A. The applicant’s full name, all other names the applicant uses or has used, the applicant’s residential address, and residence telephone number;

B. The name and address of the massage establishment where the applicant is to be employed and the name of the massage establishment owner;

C. The names and addresses of any and all previous establishments where the applicant has been employed as a massage professional, including evidence of continuous practice of massage therapy in the city since January 1, 2010;

D. A portrait photograph of the applicant at least two inches by two inches, together with a complete set of the applicant’s fingerprints, which shall be taken by the permit administrator or his/her agent;

E. Written proof that the applicant is over the age of eighteen years;

F. A signed affidavit that the applicant is not aware of having any contagious and/or communicable disease capable of being transmitted through the performance of massage;

G. A copy of a diploma, certificate of graduation or transcripts of course work from an approved school showing satisfactory completion of one hundred hours or more of nonrepetitive curriculum, with a passing grade or better in health theory, health care, anatomy, physiology, psychology, biomechanics, or kinesiology or similar curriculum;

H. A statement signed by the owner or operator of a massage establishment indicating an intent to employ the applicant as a massage professional (unless the applicant is the massage establishment owner or operator);

I. Each conviction, and each plea of guilty, or nolo contendere for violation of any of the following sections of the California Penal Code:

J. Each conviction and each plea of guilty or nolo contendere for felony offenses involving the sale of controlled substance specified in Section 11054, 11055, 11056, 11057, or 11058 of the California Health and Safety Code;

K. Each conviction and each plea of guilty or nolo contendere for misdemeanor or felony offenses that relate directly to the practice of massage;

L. Each conviction and each plea of guilty or nolo contendere for a felony, the commission of which occurred on the premises of a massage establishment, or in the course of massage;

M. Each conviction and each plea of guilty or nolo contendere for an offense involving the use of force and violence upon the person of another or for an offense involving the theft of property;

N. Each conviction and each plea of guilty or nolo contendere for attempt or conspiracy to commit any of the offenses listed in this section;

O. Each conviction, and each plea of guilty or nolo contendere for offenses committed in a jurisdiction outside of the state of California, which, if committed within the state of California, would fall within one of the offenses listed in this section;

P. Whether the applicant is required to register under provisions of Section 290 of the California Penal Code (registration as a sex offender);

Q. Whether the applicant, or a former employer of the applicant while so employed, or a building in which the applicant was so employed, was ever subjected to an abatement proceeding under Sections 11225 through 11235 (Red Light Abatement Act) of the California Penal Code or any similar provisions of law in a jurisdiction outside the state of California; and

R. Whether any permit to engage in the practice of massage as a massage professional or otherwise has previously been denied applicant or revoked, and, if so, the circumstances of the denial or revocation.