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City of Stockton HoteWotel Permit to Operate Application Page 2 1. Are you currently or have you ever owned/operated, managed or worked at a hotel, motel and/or residential hotel/motel? [M Yes ❑ No • If so, please provide the following information and answer the following questions separately for each facility(you may attach an additional sheet of paper if necessary): Name of facility(s): Qaf f&c jr— r-sd _r^A Address of facility(s): !7 S5 N• K1 Ism 1�1� SIVC40M , CK 052,0s IJ • How long did you own/operate or work at the facility(s)? AOfi VJT • What was your capacity at the facility(s) (i.e., Manager, desk clerk, etc.,)? >D�Lv��W10-41V Was the facility(s) you listed above ever cited for health, safety, fire and/or building code violation(s)? 7Yes ❑No ➢ If so, were all corrections and/or repairs of those violations completed and approved i within the time required on the citation? ZYes ❑No • During your involvement with the facility(s), has there been repeat citations for health, safety and/or building code violations? ❑Yes ,❑No In the past five years, has the facility(s) ever been cited for violations, and subsequently vacated due to corrections/repairs not being completed? ❑Yes F'No 2. How many managers do you employ at your facility? r 3. In the past three years, have you ever had a Permit to Operate denied, revoked or suspended within the State of California? ❑ Yes V No ➢ if so, please provide the reason for denial, revocation and/or suspension and the location that the permit was denied, revoked and/or suspended: 4. Have you ever applied for a Permit to Operate using a different name? ❑ Yes ZNo ➢ If so, please provide the other name: 5. As the property owner, operator, manager and/or lessee of a hotel/motel, within the last five years, have you terminated your lease, defaulted on your loan, or otherwise discontinued your association with the property while violations, as cited in a Notice of Violation, Notice and Order, Administrative Citation, etc., were still outstanding? ElYesgNo ➢ If so, please describe: **Fees are effective from 07/01/2023—0613012024