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Please provide all information requested; an incomplete application may delay approval <br /> 10 FACILITY INFORMATION <br /> Name of Facility: Plaza Perks <br /> Street Address: 306 F. Main St <br /> City: Stockton CA Zip Code: 95202 <br /> ❑ FORMER NAME OF FACILITY <br /> G&J Coffee Co <br /> ❑ BUSINESS OWNER INFORMATION <br /> Business Owner Name: Parents by Choice Inc <br /> Home Address: 306 E. Main St, Suite 300, Stockton, CA 95202 <br /> Mailing Address: P.O. Box 690158, Stockton, CA 95269 <br /> Telephone Number: (209) 275-2487 <br /> Ll' RROPERTIG„0-N14NERINFORiVIi4TION <br /> Property Owner Name: Parents by Choice Inc <br /> Home Address: 306 E. Main St, Suite 300, Stockton, CA 95202 <br /> Mailing Address: P.O. Box 690158, Stockton, CA 95269 <br /> Telephone Number: 275-2487 <br /> ❑ CONTRACTOR INFORMATION <br /> Name of General Contractor: <br /> Mailing Address: <br /> Telephone Number: <br /> Contact Person on Site: <br /> Site Phone Number: <br /> ❑ UTILITIES:• <br /> Source of Facility Water Supply: Cal Water <br /> Backflow Protection: <br /> System to be used for Liquid W ste Disposal (Sewage): CitV of Stockton <br /> Solid Waste Disposal to be provided: Building dum ster <br /> Grease Interceptor: <br /> ❑ FOOD- `FOjWTIO;N <br /> List food(s) to be served and/or provide menu: <br /> Coffee. tea. smoothies- bakery items, pre-packaged items <br /> O OPE. TION 1- POR <br /> Anticipated Business Hours: Open: 7AM Close: 5PM <br /> Anticipated Number of Employees: 4-5 <br /> RECEMED <br /> SEP 112020 <br /> 'ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> EHD 1601 4 PLAN CHECK GUIDE <br /> 715117 <br />