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Home My WebLink AboutCAG2012-1002 - Original - Washington State Motorcade - Authorized Emergency Vehicle Permit - 02/15/2012STF"TE CIF PIAsI.! ! NCTOFJ WAS F{ ! NCTO I{ ST,4TE PATP-{-} L Ceneral Adnrinistration Euilding o P0 sox 42600 * Olyrnpia, wA 985S4-2600 6 (368) sg6-4CI@0 e www.Bl/sp.wa.gov February 15,2012 Mr. Steven Bartel Washington State Motorcade 44Og SW Admiral #122 Seattle WA 98116 CFE IAISTI rq*E S. 6 RECOi t{E Covernor S Jason G ment and a Relations JGB:mvg Enclosurecc: Chief Kathy Atwood; Everett Police Department Chief Jim Collyer, Puyallup Police Department Chief Al Cornpaan, Edmonds Police Department'Chief Carol Cummings, Bothell Police Department . Captain Jeff DeVere, District 1 - Tacoma Chief Jon Fehlman, Bainbridge lsland Police Department Captain Ken Ginnard, District 2 - Bellevue Chief Andy Hwang, FederalWay Police Department Chief Steven Jensen, Lynwood Police Department Captain Bob Johnson, District I - Bremerton , Chief Bob Lee, Auburn Police Department Sheriff John Lovick, Snohomish County Sheriffs Office Chief Kevin Milosevich, Renton Police Department Sheriff Paul Pastor, Pierce County Sheriffs Office j# fiN R. EAT6$TE Chief Dear Mr. Bartel: Y-our app,lication for an Authorized Emergency Vehicle Permit (AEVP) for Washington State Motorcade has been approved and ig enclosed. Please note that your application expires on Febru ary 15, 2013. This office will need to receive a complete reqewal applicatiop prior to February 15 each year in order to renew your permit. if there are missing signatures, vehicle certificatioh of equipment or driver background checks, a renewal.application will be denied. lf your permit expiies and a complete renewal application is not received, yqu will be required to start the permitting process ovei. This will reqdiie that all vehicles are re-inspected and all drivers comilete a new background check prior tb approval. lf you have any questions please call Ms. Melissa Van Gorkom at (360) 596-4017. &qig Chief Linda pillo, Bellevue police Departmentg3plqin Jeff sass, oirlii.ii -'ffi;;fril" , , : lc_hidf Ken Thomas, r"nt'ijlir.'oJ*ir"nt Ms. Metissa Van obgkgm, equ,prJni and Standards Review Unit9llur Michael Viila, TukwilF;il;;p'artment c h ier Greg witson. fi ;;ii;k"'il;;#potice Depa rtm entChief Jim Zoil, Enumctaw Fofi.. OJp#runt AUTHORIZED EMERGENCY VEHICLE PERMIT ORIGINAL APPLICATION EEm-ilsHrflotol{ 6talE PltioLW WASHI NGTON STATE PATROL EQUIPMENT & STANDARDS REVIEW UNIT GENERAL ADMIN ISTRATION BLDG PO BOX 42600 oLYMP|A WA 98504-2600 Person, Company, Department, orAgency (if a person, must list agency/department representing) DATE APPROVED Februarv 15. 20LZ VALID UNTIL: CAPTAIN Use Only) /L {4 This application must be submitted by the Chief Executive of the firm or corporation making application Please type or print in ink. Address U(a ? g//i,-a.-{ ff4P z-s" City *l4lu State 6dt* zip f&/{6 Phone '1 .-.E-mail Vehicle lnformation: List allvehicles you intend to use as an authorized emergency vehicle (if approved). For each vehicle, provide both the vehicle and emergency equipment information as outlined below. Please note that the ernergency equipment may not be installed on these vehicles until the appropriate signatures are obtained forthis application and temporary vehicle permits have been issued. 1 2e// 7*E q7 \/MAKE MODEL 3,feeae-n F"r-fZ-7 LICENSE NO VIN YEAR T t REG N MAKE MODEL . SIREN LAMP COLOR(S) ccP OTHER EQUIPMENT: EM EQU PM MAKE. IN eSIREN LAMP COLOR(S) MAKEIMODET t rz/t n orurn EeUTPMENT:in"r/o, trtnP YEAR MAKE & ELM LICENSE NO / l{-2/Ftrn /p?t 6',gq ogf REGISTERED OWNER Cr*'4 ,F{*r*"/*r- VIN 3000-323{07 (R 12/09)Page 1 of4 AUTHORIZED EMERGENCY VEHICLE P ERMIT ORIGINAL APP ffiLICATION MODEL FL/'/P VIN (/{ 0 Ft{pt it Fut tt6 {n'/ rt D erl EMERGENCY EQUIPMENT INFORMATION INSTALLED MODEL 4 OTHER EQUIPMENT: E NO. MAKE EL EMERGENCY EQUI PMENT INFORMATION INSTALLED MAKE MODEL SIREN LAMP COLOR(S) LAMP MODELMAKE REGISTERED OWNER EMERGENCY tnsrnrleo MODEI- IPMENT SIREN LAMP COLOR(S) OTHER EQUIPMENT: Note: You may add an additionalsheet must provide the vehicle and equipment if more vehicres need to be added to the permit. Any additionar sheetsinformation in the same rormat "s ai;;;.'- 2. tsc arf f*^uo. u{ .ted-af ce5 3000-323-007 (R 1ZO9) Page2of 4 AUTHORIZED EMERG ENCY VEHICLE PERMIT ORIGINAL APPLICATTON H,E*HffiW 3 Authority: Explain authority outlined under statute (Revised Code of Washington) that allows the vehicles' operators to use emergency equipment for the purpose outlined under part 2 of this application. frr f6* ,{t,zrf,zi e " f fut?et''*/ ?f'@/"Fl'at ft*aviZ; tu ft.ei v/"3?-r7a/u6"'77. 6 eq*/Jq.eJ ;e 1-/r;t /er'*rf 4. Geographic Area: Check which types of roads you intend to operate on and state the specific geographic area(s) in which the vehicles shall be used as authorized emergency vehicles (city, county, etc.). (Certification from each pr;imqry jurisdiction is required under part 7 of this application.) tl City Streets (list *fu+r, /Ze//ervu.., E{*-oot+Fa*-'*" L.- : F,v.4 8ufr.1 n county (list all t] State Routes/lnterctajr;sr,s-Ify"fqet:,fzg,"r2+ at. 30 5. Operators: Please list all drivers that you intend to have operating the vehicle(s) listed in this application. Please note that these drivers wiil be required to undergo a background check a1d pe ?PPlgYed.priot:to lhe opefatiqn of any emergency vehicle listed in this application. " " OPERATOR/DRIVER.OPERATOR/DRIVER OPERATOR/DRIVER 17e a'* R u*fa/ ?.or* P&o-./.-- {-^e2 /1.o*l (Use additional sheet if necessary) 6. Permit Validation: I certify that all of the information given in this application is correct to the best of my knowledgeand providbd in its full format to the undersigned chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes) of each primary jurisdiction in which the vehicles are to be used as authorized emergency vehicle(s). t understand that if permits are issued, the driver may not use the vehicle for private purposes unless all emergency equiprnent is removed or covered. The driver must exercise due care and caution and must oney att tratfic laws. The inappropriate or misuse of authorized emergency vehicles may result in criminal or civil liability as well as cancellation of the emergency vehicle permits. ln addition, I understand that if I wish to add a new driver or vehicle to this permit, I must receive prior approval before they are authorized under this permit, and that it is my responsibility to ensure that a copy of this permit and listof approved drivers are present in each vehicle at alltimes and must be presented to law enforcement, if requested. Signature Title 4tre-ri,!.*,f oFFrcER) Name 9feo B-.*fel t'j 3ooo-323-007 (R 12109) (wPE OR PRrNT) Date z Page 3 of 4 a' All of the information given in this application is correct to the best of my knowredge and provided inits rurl rormat to the ,,iJlirisjr"o .hit i;; ;;r;-;;;;i';d;r-* ri; "'i'ii'1ir the vehicre i.s to be used:".1,fri?['.T':il3il3;:t?"i1ki];ffi,fii;'iil,T,",#:' which the vehicres are to be used asb' None of the drivers' to the best,of my knowledge in.the rast year, have been convicted of, nor servedany sentenc'es or periods of prooation ror any ieionies, nor arrested and convicted of a drug or arcohorviotation orilesat 'rG;; po;5;",.j,;;;i;;6'i irili oE;" required to resister as a sex orrender, norhave any of th6m oeen ai;-u-o"iJatea incomp"eirnifiin""nu.c' only the vehicld(s) and equioment listed in this application will be used as ouilined in this application,and that onlv the ,iperutori-iliteo urilr tnii'irlirFiii*irr drive the vehicre(sj. *J3:,illlffi i3liil:t?,ffii:t,J;."ry":er incharse of overseeins this permit, I understand rhat if ilre permit is a' ' frl,*l:Tj',.q:?1$J!:t permit uses.,n. u.n,"," "r prrvate purposes'unress ar ernersency.equipment is 6. Permit Validation I certify that: b c. I understa liability as addition,I understand that it i;d nvers are nt iri each vehicle atprese AUTHORIZED EMERGENCY VEHIC LE PERMITAPPLICATIONRENEWAL re,spon_sibility to ensure that a copyau ttmes and must be presented tro .oR PRTNT) e4A I v lir< Date of this permit and list of approved law enforcement, if requested 7 or:'DCVq,LF Signature Name -Title(cHrEF oFFtCER) 7. Certification: Tunress.diiinJi"rfffiy:rnif,lXflii?'',i!i!!,":,fif":Fff',g""J1,:liirli.j"":f;i.#'ilyj,#1,::oiioTo*o firefighting purpo !!!ioeniy',"i;,,r":,,:li:li+?'S?e+,iitffi,,t tH;Ej#ill*i*:"t"""o",i;:X#;f:;X,llf,::ffi::ii"",ilflXlX'J"li,X1?S?S,ffiiJ[tjfi[,*?J"'uf'1F,Hrj;1id:,igiT'?ile poriticar sub-division rhe eh,"4 t9 'r 3000€23{06 (R 12De) L_grc*af}-1f\." t* f - \3S€ oF Gr6r-s.{- fiEe ^cITYcF * * + AUBURN. .:::"JI' WASHINGTON FoBEce Depcrtrnenl 340 E Moin Sl, Suite 201 * Auburn WA 98002-5548 * www.ouburnwo.gov * 253-931-3OOC October 31,2011 Bob Lee Washington State Motorcade Steven Bartel 4409 S.W. AdmirdffiA2 Seattle, WA 98 1 16 Mr. Bartel, The purpose of this correspondence is to advise you that I have signed your renewal application for the authorized emergency vehicle permit. This authorization is granted, with limitations. Washington Administrative Code {WAC} 204-36-040 (e) limits your escoris to be used only for funeral escorts. No.other escorts are perrnitted or authorized within the city limits of Auburn. ln addition, the' issuance of an emergency vehicle permit does not relieve the driver'of an emergency vehicle from the duty to drive wlth the regard to1 t[e qafgty of all persons, nor shall sueh provisions protect:thei'i driver from-the consbquencbs of hisiher disregard for the safety of othters ancl it does not grant police authority to the operators of said vehicles. Further; a privately-ernployed funeral procession escort driver, acting without public agency police commission authority of any sort, rnay not act as a traffic officer for the purposes of RCW 46.61,050 (obedience to traffic control devices) when he/she is escorting a funeral procession, Your escort afficers may n*t, unless otherwise gavernmentally commissioned ta do sa, direct the traffic flaw in contravention af the instructions of an otherwise appticable traffic cantrol device. Should you have any questions, please do not hesitate to contact me. Sincerely, .1:1,:'-; ':__. i. t: " '', :i) i .. :-::-'r t'i !r: Armt IR N x MoRE THAN yot I IM AGINFT-) 6. Permit Validation: I certify that: ln addition , I understand that it is mdrivers a re present i[ each vehicle ' 'Signature Name Please type or: print: Sign Na (Please print) _ Phone ., ctions AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION REN EWAL to ensure that a'co py of this permit and to law enforcement,must be presented . -Title Date FRTNT) EDM,_W a' 'All of the information given in this application is correct to the best of my knowledge and provided in: its full format to the uridersisneo cnieit rlw eniJrcJr"nt officer orfire orr'ier 1r the vehicle is to be usedfor firefighting purposes) olE"9l prffiry j;;;;,;# in which the vehicres are to be used asauthorizedernergencyvenicte(s)., rr-r'v-!v'v,. b' None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor servedany sentences or periods of piobation -f"i ;"ti"'6niur, nor" arrested and convicted of a drug or alcoholviolation or illegal 'use or posiessio.n ot;;G;, ;; ;i9! required to regiiter as a sex offender, norhave any of them been airjudicated iniomp-"iLnioiinr"n*.c 3#1fl?#,}'?i"J'J;?:,:tri[t?iffi:?iit,l5,.;i,i,[?fnly,ll3;.;::,:.1;",,,,ed in this app,ication, *:,j::,1[i3iry i.L,i*:t,f",:tff"?f.:er in charol or.overseeins this permit, r understand that irthe permit is d' ' l:t *:Tj::?1$J!:t permit uses tne vehicte tor prruate purposes'untess an emergencylequipr;nent is b' No driver other than those listed-under this approved permit operates the vehicle(s) listed unless ailemergency equipment is removed o, "ou"rJd.-iii*i;n to iioT ne;j;i;"; or vehicre to rhis permit, rmust receive prior approval before tney aie aut'bi-il"a under this permit. r or venlcle t0 this pern c- The driver must exercise due care and caution and must oouy "rr;;;;"*r.I understand that the inappropriate or misu.se of authorized emergency^v-ehicles may result in criminal or civilliability as weil ar ".ncerijti;;;il;'r;"rn-,it ". ouflined under chapter 204_36 wAc: certification: This renewalapplication ":11,1:ln-o Emergency].g!lcte permits wittno( be hcceptedunless CERTIFIED Qv t-rre "liJfi;;;;'fttement officer oi nrE "niut (if the vehicre is to be used forfirefighting purposes;"or_"::l oiiql.r!'ilii.oi.tio'i in *rri.n'tiiJ,i"ni"r". are to be used as authorizedemergency vehictes (see part 4 of tnisippfic-ationl_f liig.t{ilation is made by the chief of a taw::H::fitJ1"X111'J"li,X',il?S,ffiiJ[Tfr:#J'c'itiHHDLv tne head orrhe poriricarsub.division rhe "l hereby certlfv ilrati !3ye reviewed ,.h,, :ljif..u^:pptiqation;Jhat.I a.m aware that the appticant intends touse the vehicle(s) and emerge.,y ;q"ifieli iirte["JJlpJJiii."irv described in part 2 of this appticarion; thaia need continues to exist.in Fry.;drisrJicfr; f";iilri.i;j[J#E io be used as ;uino-rizeo emergencyvehicles and that the applicanf fi;; th;;ifq1i3t" qlili*ty;;":."ribed in part 3 of this apprication ro .operate such equipmeni; ano I rinow ori'd r""ron why this apptication should be denied.,, : list of approved requested 3000-323{06 (R rzog) caerlart 1/t VAf y lir<a E-Mail Title Paoe 4 af s av AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H.M"HffiWT 6. Permit Validation: I certify that: a. All of the information given in this application,is correct to the best of my knowledge and provided in; I ' its full format to the undersigned chief law enforcement officer: dr fire chief (if the vehicle is to be used authorized ernergency veh icle(s). None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offender, nor have anyof them been adjudicated incompetent or insane. Only the vehiclei(s) and equipment listed in this application will be used as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the primary holder or executive officer in charge of overseeing this permit, I understand that if the permit is issued, it.is my responsibility to ensure; a. , UHUiffiFqffifff,,this permit uses" the vehicle for private purposes unless all emergency,equipment is remoVed or'covered. b. No driver other than those listed under this apprbved permit operates the vehicle(s) listed unless all emergency equipment is removed or covered. lf I wish to add a new driver or vehicle to this permit, I must receive prior appioval before they are authorized under this permit, c. The driver must exercise due care and caution and muqt obey all traffic laws. I understand that the inappropriate or misuse of.authorized emergency vehieles may result in criminal or civil liability as well qs canceliation:of this permit as outlined under cnfpteizOa-36:WAC. , :' :: : ln addition, I understand that it is my responsibility to ensure that b c. !. drivers are iri each vehicle at alltimes and must be prese (cHrEF OFFI9ER) of this permit and list of approved law enforcement, if requested. .Y cru,.Vh lrira-= ^=a Signature Restrictions 'Title Name S*e ue, i Fo,*ki/ r===rr,_,, Daie 7. Certification: This renewal apptication for Authorized Emergency Vehicle Permits will nst be bccepted unless CERTIFIED by the chidf law enforcement officer or firE chibf (if the vehicle is to be used for firefighting purposes) of each primary jurisdiction in which the vehiclds are to be used as authorizeri emergency vehicles (see part 4 of this application). lf the application is made by the chief of a law enfglcelnent agency gr.fire department, it must be CERTIFIED by the head of the political sub-division. The certification must contain the following language: -<.\C..-i-tr'e- u4e-\3000-323{06 (R 12109) -, rrk\c.av'i 5i\:.'\'z af,\D<2-etzaP,i \r-\^.' - \--1t^a r:L q-Vr 9 n 6t-, Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWA EEm-\WrL 6. Permit Validation: I certify that: ln ad dition, drive rs are Signature Name " a' All of the informatien giveri in this applicdtfori is iorrect t9-!he pes!of my knowtedge and provided in' its full forrnat to the ,,io"itign;d;hHf iil ;#""r"rt officer or fire chief (if the vehicle is to be usedfor firefighting purposes) ot6acrr t;i#ry jr;;;;;t'i,;; ir wh jch the vehictes are to be used asauthorized ernergbncy veh icle(s).' b' None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor servedany sentences or periods of probation pr an/ielonies, nor arrested and convicted of a drug or alcoholviolation or illegal 'use or posiession or otrg;, noi'oJun required to register as a sex offender, norhave anyof them been abjudicated i;";;""i1;t-oiinsane.c SjxH?ffi'!'?l'x'j,x?:,:trp,[:Tffi:?ii?J[F,.;5i$?fiffilJJll3;J::,x.1jou'ined in this app,ication, As the primary holder or. e.xecutive officer in charge of overseeing this permit, I understand that if the permit isrssued, it.is my responsibility to gnsuie:- a' I i:t*:Tl::?1SJ!:t permit uses tne venicte for prrvate purposes'untess an emergency.equipment is b' No driver other than those listed-:qTj.l5 lfpigyeq permit operates the vehicte(s) tisted untess a1emergency equipment is removeo or covered.' lf I wish to iao i nd* irii"io, vehicle to this permit, Imust receive prior approvalbefore tneyaie autnbiileo ,"69r tnid p"r,ili. -' c' The driver must exercise due care and caution and must obey all trafRc taws, I understand that the inappropriate or misu.se of au,thorized.emergency vehicles may result in criminal or civilliability as wetl as cancelidtiofi ;ilhisliiiiiiit "" ouflined under chaprer 204-36wAc. to ensure that must be prese 'Title s;|"/e-zrY(cHrEF Date certification: This renewalapplication tultlt!:!*d Emergency-Ve-hicte permits wiil no[ be bcceptedunless CERTIFIED by tlte cnier'riw entbr-cement officer oi nrE "i,ri"r (if the vehicte is to be used forlt:lgl]'lqf1'p.o;estg-e3lqo,t;Tii'jliiJoi.tion in *ni"n'tnJu-unirr"" are to be used as authorizedemersency vehictes (see part 4 of this appti"iq,g"irg@'g.[ril;ii",it ,"1r" ovin"inief of a tawenforcement aoencv br firb aepartmentllt"must oei crnTlFlEto-by the head of the political sub-division. Thecertifi cation m tist cdntain tH ;5t;ilft' l* i r"s., CTYPF .oR PRTNT) 3000-323{06 (R 12109) Vlt y sir<a Pane A aJ E AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H,R"HffiWtr 6. Permit Validation: I certify that: a. All of the information given in this application is correct to the best of my knowledge and provided in| , ' its full format to the undersigned chief law enforcementofficer or fire chief (if the vehicle is to be used for firefighting purposes) 9{ eacn primary jurisdiction in which the vehicles are'to be used as authorized emergency vehicle(s). , : b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane. c. Only the vehicld(s) and equipment listed in this application will be used as outlined in this application,' and that only the oplrators listed under this permit will drive the vehicle(s). As the primary holder or executive officer in charge of overseeing this permit, I understand that lf the permit is issued, it is my responsibility to ensure: a. " No drivFr listqd in.th.is permit !ggs" lhe vehicle foq' private purposes unleqs all emergency.equipment is removed or'covered. b. No driver other than those listed under this approved peimit operates the vehicle(s) listed unless all emergency equipment is removed or covered. lf I wish to add a new driver or vehicle to this permit, I' must receive prior approval bgfore they are authorized under this permit. c. The driver must exercise due care and caution and must obey alltraffic laws. I understand that the inappropriate or misuse of authorized emergency vehicles may result in criminalor civil liability as well as'cancellation of this peqit as outlined under chap!er,204-36:!V4O: " , ln addition, I understand that it is my responsibility of this permit and list of approved , law enforcement, if requested.drivers are nt in each vehicle at all times and Signature 'Title Prret; ,/e-nY ' (cHlEF. Name Date Certification: This renewal application for Authorized Emergency Vehicle Permits will not be bccepted unless CERTIFIED by the chief law enforcement officer or fire.chief (if the vehicle is to be used for firefighiing purposes)-of each primary jurisdiction in which the vehicles are to be used as authorized emeigeniy veiricles isee part + of tnii ipptiCation). lf the application is made by the chief of a law : enforcement agency or fire department, itmust be CERTIFIED by the head of the political sub-division. The certification must contain the following language: ' 'i! hereby certitv that I have reviewed this entire appliqation;.that I am aware that the applicant intends to use the vehicle(s) and emergency equipment listed as specifically described in part 2 of this application; that a need continues to exist in my jurisdiction for the tisted vehicles to be used as authorized emergency vehicles and that the applicanf has the appropriate authority as described in part 3 of this application to . operate such equrpmentq and I know of rid relson why this -application should be, denied.l , . . . Please type or print: Signature Name (Please Print) Phone Restrictions '' Jurisdiction E-Mail' 3000-323{06 (R 1209) Zlr Aa*;frArt& Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT EEM,mW 6. Permit Vatidation: I certify that: ln addition, I understand that it isdrivers are present in each veh icle at APPLICATION RENEWA Date L ' ?'"' : All of the information given in fris Spqlrgation is correc! to_1he,best of my knowledge and provided in for firefighting purposes) oi;;;h il^"'.v j*i!##n in which the vehicres are to be used asauthorized emergbncy vehicle1s1.. . 'J J-"vy'v'v,, b' None of the drivers, to the best of 1y knowledge in the last year, have been convicted of, nor servedany sentences or periods of probatidn JoI ;tfilni"., nor iresied and convicted of a drug or alcoholviolation or illegal 'use or posiession of A;G;, n.'uf"n required to register as a sex offender, norhave anyof th6m been afficateo incomp1iLnt-oiinsane. r as a sex offender, noc 3iXlffiffi'?'?l"J?,??:,:tr1[[ili;;:?iit1t;i,i;;i5?Jil]ff.H8,111",''.ed in this app,ication, t:J3:,ifllXry igi:'":t?,,fi$'#"X[:erin charol or.overseeins this permit, I understand rhat irthe permit is a' ' Lt ltJ:atj'F::1$j[t permit uses the vehicle for private purposeq'unless an emergency.equipment is b' No driver other than those listed,u.nder this approved gelmit operates the vehicle(s) listed unless allemergency equipment is removed ot covetei.'iii*i.n to'a-oo"a l're* d';i;"r or vehicle to this permit, Imust receive prior approvar befoie ir'"v "iurutrlilil"? ,].o"ij6J;;;;i. = c' The driver must exercise due care and caution "na rrrt ;;; ;; ;;;;*r. I understand that the inappropriate or misuse -of au,thorized.emergency vehicles may result in criminal or civilliabilitv as weil as canceriji6;;? il;'Rur*it ", ouuined under chapt er 204_J6wAc: resp.onsibility to ensure 11,1a.cqnV of this permit and tist of approvedall times and must be presented'tb raw unforc"*"nt, if requested.' I r- i 1 .. Signature Name lease type or Signature Name (Pl6ase print) Phone s e ():Y(cHtEF .oR PRTNT) ,r[,"ci1\ T'i,"u'' \ certification: This renewalapplication f"^:11t1:g.9J Em?rgelqyVehicte permits wifi not. be bcceptedunless CERTIFIED ?l/ tl,u it dri"* l,rtoicement officer or fir-e chief (if the vehicte is to be used foirirerishiins PurPoses) d "?;h, piT;.i'il;il';ri.;ii i''j'*[Li'tii;verricies are io be used as auihorizedemergency vehicles (see part 4 or tnis ifpricatio;t-tl{;.gdtication is made by the chief of a tawenrorcement agencv or firb aepartment, it must oei cenfrFrHo;/ru'i;H:iir{J'pliti"ur sub-division. Thecertification must cdntain the rbuowidb;gr;;; :', :*- '?-'2a<7 ,rrru qz ,-.Jurisdiction aaqli 3000-323{06 (R lZOe) ac2t I rtA* v tir<a E-Mail Paqe 4 of 5 4. us AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H.F."-EmWtr 6. Permit Validation: b. No driver other than those I emergency equipment is re proved permit operates lf I wish to add a new a. All of the information given in this application is correct to the best of my knowledge and'provided in its full forrnat to the uideriigneO chidt law qnforcement officer or fire cnL'ef lif ,tne v-ehicle is to be used for firefighting purposes) of iach primary juiisdictirin in whic-h,the vehicles are to,be'used as authorized ernergency vehicle(s), b. None of the drivers, to the best of my knowledge in the last year, have,been convicted of, nor served any sentences or periqds of probation for any felonies, nor arrested and convicted of adrug or alcohol violation or illegal use or possession of drug6, nor been required to register as a sex offender, nor have anyof them been adjudicated incompetent or insane. c. Only the vehicki(s) and equipment listed in this application will be used'as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the primary holder or executive officer in charge of overseeing this permit, I understand that if the permit is issued, it.is my responsibility to ensure: No drivBr listed in.th.is permit gggs" the vehicle fo1 privqte purposeq unleEs all emergency.equipment is remoVed or'covered. a. Name 5*e:ue, Do,.fut TYPE OR PRINN Signature Name: (Please Piint) Phone Restrictions the vehicle(s) listed unless all driver or vehicle to this Permit, I tut Vrd isted under this ap moved or covered.' must receive prior approval before they are a uthorized under this permit. traffic laws. I understand that the ina or misuse of a , result in cr,imlnal qr.civil liability as wellas ln addition, I understand that it is my responsibility ensure that a copy of this and list of approved drivers are present iri each vehicle at alltimes ust be presented to law nt, if requested. Date Jurisdiction (R 1209) c t+e*I c.qa I;ft ? E-Mail fr 4of5 L8/27/zgLL 1,6:2 2A593238 7A 6. Ferrnlt Vrlldrtlon: I certify that: Signature Narne 7 Please type or STEVEN BARTEL AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL Title (CHIEF PAGE 62 a. All of the Informa{on glven-in this application is correct to the best of my knowle{ge and provided in ite full forqr.at to the underaignod ctriif law enforcement officer cir,fire chicf (if tho fehicle iLto UE useOfor.flrefighting purposes) of Each prirnary jurisdiotion ln which ttre verrbreJ are to be used asauthorized emergenoy vehicle(s), b. None of the drivers, to the best of my knowledge in tho last year, have been convicted ol nor seryedany sentenc,Fs ol periods of probation _for any ielonies, nor arresied and convicted of a diug or aicoholviolation orjllegal use or pos'session- of drugi. nor bseh requireo torigGdr as e eex otfendir, norhave any of them been ailudicated incomp-etent or ineane, c. Onlv.the u:!]jgluJt]-Td,equlpment listed..in this ap,pllcation will be used es oulined in thia apptication,and that only the oparatorb listed under this parniii will drivc the-vrhille(0. ,'As the PlTary holder or executive officer in charge of overeeeing this permlt, I underetand that if the pormit ieissu6d, it.is my roeponsibility to gnsure: , . ,, . .. a' , l!o--uji!"., lietEd in.this petmlt uses. the vehicle fo;'private purpos€s unleas all emerg€ncy,equipmant isremoVed or'covered. -'r--;- b' No driver other than thoso lieted under thi6 appioved peimit operates the vehiclu(s) leted unless a1emergency equipment lE rEmoved or covered.' I I wleh to aaO'J new criver or vihJitJtoir,ii fiJimil rmust recelve prior approval before they are authorized unotr inie p"rmii. - c. The driver muet exercise due care and caution and must obey alltraffie laws. l. understand that the-inapproPrilqg or misu.se of au.thorized emergency vehicteb may result in criminal or clvilliability as wollas canceliitioi oifirts p;r'ilft;;;til;J rrd;;ipi"Tzbditi-wn;r rErwr'r' v"r'xrqr et '.'v ln addition, drivers are at lt ia.my_re.sp_onsibility to enEure that a copy of thle permit and list of aoorovedvenlcre aI ail ltmes and must be presented trc law eniorcement, if requiited. l'' Signature Name (Plcr.. Prtnu Phone (grt-.r lo)9.r, (@ Detc Date tt/r /r,Title Jurisdiction tr-[Iail FruMD certlflcatlon: This renewal ap.qlication folluth.ofged EmergencyVe-frtcte permits wifl no( be boceptedunless CERTIFIED by the cnnr raw enrorcoment omcer oiirrE lni"r tir iiti re[i;i;r'io be used rorItjlgI'lg ourp.oges)^o-f 9acn. ryrnfry,jlriiolcilori rn wr'icn t'n"-tLr,i.r", are to pe ur"o-"r-*ii[J,iLoemersencv vehlcles (:-"p_qa.1]1_o_f rhis-appricati?n).^rllrr_"epfu;il;;ls;;ii!l[" ,r,ief of a 6w ::ff,Hft',i1fi,g-"t13"il,x1?*S,ffi,;;iJ'ifrH,JrbitrnilHrjbvftft;t";ifrJ'e"il#iri,E..irfision rrre t: tt'l-f,:470 1...I ,svl ctal lt$t r lirca €r.T? Restri ctions I AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H,F-HMWtr 6. PermitValidation: I certify that: Signature Name Please type or print: Signature Name (Please Print) Phone Restrictions a. All of the information given in this application is correct to the best of my knowledgq 3ld provided in its full format to the undersigneO cnidf law enforcement officer or fire chief (if the vehicle i9 to be used for tiietighting purposes) of -each primary jurisdiction in which the vehicles are to be used as authorized ernergency vehicle(s), b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentenceJ or pbrioOs of probation for any ielonies, nor dnested and convicted of adrug or alcohol vioiation or illegal use or pos'session of drugi, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane. c. Onty the vehicld(s) and equipment listed in this application will be used as outlined in this application, andthat only the 6peratori listed under this permit will drive the vehicle(s). ' :'r'i ' 'i As the primary holder or executive officer in charge of overseeing this permit, I understand that if the permit is issued, it.is my responsibility to gnsure; a. , No driver listed in.this permit uses" the vehicle fo; private purposes unleEs all emergency.equipment is removed or'covered. b. No driver other than those listed under this apprbved permit operates the vehicle(s).listed,unless all "muig"n"y equipment is removed or covereil.' lf I wis'h to add'a new driver or vehicle to this permit' I mustieceVe iribr approval before they are authorized under this permit- c. The driver must exercise due caJe and cautio. n and must obey all lraffic.laws. Title (cHrEF-OEFICER) OR PRINI) Date Date ' Jurisdiction ri'e &fbi* 6l Tb,lic{r, '. Certification: This renewal application for Authorized Emergency Vehicle Permits will not be'accepted unless CERTIFIED by the itri6f taw enforcement officer or fire chief.(if the vehicle is to be used for niinghting puiposesl'of each primary jurisdiction in which the'vehiclds are to be used as authorized "."igenif uehictes ir"" p"rt + or tnis apptication)._lf the. application is ma.de-!.y the chief of'a law entor|emeint agency'oinrb o"partment, it musi oei crnlriED by the head of the political sub-division. The certification must cdntain the fbllowing language: that t 30oG323{06 (R 1209) lrJ E-Mail {"\n,C ,}fi Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL EtsM,_WF 6. Permit Validation: I certify that: I understand th at the inappropriate or as cancellation of this a' All of the informa.tion given.in this application is correct to the best of my knowledge and provided in ro1lrefighting purposes) of-each primary'jurisdiction in which the vehicles are to be used asauthorized emergency vehicle(s) ,' - "': --' b' None of the drivers, to the best of my k-nowledge in the last year, have been convicted of, nor servedany sentenc.es or periods of probafidn 1o1 in/ieionies, nor arrested and convicted of a drug or alcoholviolation orillegal use or pos'session of orrgd, nr u""n required to register as a sex offender, norhave any of them been ai.ludicated incompittbnioiNi";;l- -- c' only the vehicle(s) and.equipment listed.in this application will be used as ouflined in this application,and that only the dperatori tisteo unoei tnir p"r"iii*irr ;;it;;'iil;"hi;[(r) ' As the Plf aq' hol<ier or executive officer in charge of overseeing this permit, I understand that if the permit isissued, it.is my responsibility to gnsure:- -"- ": -. .-.". "-"' a' ' llo dfvsl li-sterj in th.is permit y9gs. [he vehicle for private purposes'unless all emergencyrequipment isremoVed or'covered. b' No driver other than those listed u.nder this approved peimit operates the vehicle(s) listed unless allemergency equipment is removed or covere,l.' tf t wish to add a new Oriver or vehicle to this permit, Imust receive prior approvar before they are authoriied u;d;rlhid ;;;;ii. - c' The driver must exercise due ".r" "ni caution and must obey all ir"*" i"*r. liability as well Signature Name misuse of authorized emergency vehicles mpermit as outlined und er chapter 204-36 ln addition, I understand that it is my responsibility to'ensure that a copydrivers are present in each veh icle at alltimes and must be presented to list of approved if requested. ,-Title Date Y Gertification: This relgwal f P,Plication for Authorized Emergency Vehicle perrnits wiil no[ be bcceptedunless CERTIFIED by qe chief law enfortement offjcer or fir'elchief (if the vehicle is to be used for, l':!91]'19 purposes; of each pliriiw jtrirJ;i# i;'ffir"nttiil''Lni"tes are to bej used a$ authorized ;ffi qiffi i:,:.8:.;,:;,3*3#,ll:;;t'*t:1"*"gn:r,r;r,,il;:tgt;liji""",#:iiifl L1lr*.,',n"certification must contain the fbllowing I'anguage: - --' '-- ' (cHtEE 9* fl'ry sOOO-323{06 (R 1Zo9) ,aer7 cacy I VAf v Siraa Page 4 of 5 t AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H.E*HMWtr 6. Permit Validation: I certify that: All of the information given in this application is correct to the best of my knowledge and provided in its full format to,the undersigned ctridt taw enforcement officer-or.fire chief (if-the vehicle is to be used for firefighting purposes) of each primary jurisdiction in which the vehicles are'to be used as authorized ernergency veh icle(s). None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane. Only the vehiclti(s) and equipment listed in this application will be used as outlined in this application, and that only the operators liEted under this permit will drive the vehicle(s). As the, piif ary holder or executive officer in charge of overseeing this permit, I understand that if the permit is issued, it.is my responsibility to ensure; a. , No drivBr listed in.this permit uses. the vehicle for private purposes unless all emergency,equipment is removed or'covered. b. No driver other than those listed under this approved permit operates the vehicle(s) listed unless all emergency equipment is removed or covered. lf I wish to add a new driver or vehicle to this permit, I must receive prior approvdl before they are authorized under this permit. c. The driver must exercise due care and caution and must obey all traffic laws. or misuse of authorized emergeno)/.vehicles may result in eriminal or'civil is permit as outlined under chapter WAC ln addition , I understand that it is my responsibility to ensure that a copy. alltimes and must be,presented to it and list of ap drivers are present in each vehicle at if requested. Signature .Title, Pn*t; "/.zY(cHrEE Name Sceui,n ,B|.fo-l Date 6rv3e.on enrurl a- b c. 'ii. 7 Certification: This renewal application for Authorized Emergency Vehicle Permits will not. be bccepted unless CERTIFIED by the chi6f law enforcement officgr or fir-e chibf (if the vehicle is to be used for ' fireiighting purposes) of each pr:imary jurisdiction in which ihe vehicles are to be used as auihorized emeigendy'veiricles isee part 4 of thiiapplication). lf the application is made by the chief of a law enforcement agency or fire department, it must be CERTIFIED by the head of the political sub-division. The certification must contain the following language: , ' , "l hereby certifv that I have reviewed this entire appliqation;.that I am aware that the applicant intends to use the vehicle(s) and emergency equipment listed as specifically described in part 2 of this applicdtion; that a need continues to exist in my jurisdiction for the listed vehicles to be used as authorized emergency vehicles and that the applicanf has the appropriate authority as described in part 3 of this application to , operate such equipment; and I know of no reason why this application should be denied." , ' ,.. . .. Signatule , D-ate t?.,8!: r,! ,, Title Name,r : ,'Fbpt(Please Print) Phone Jurisdiction E-Mail .Jf LI Restrictions 3OOG323O06 (R 1209) 4*faaay t.?At v Eirca Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL 6. Permit Validation: I certify that: 1!l :lt!g informa.tion given in this application is corrbct to the best of my knowledge and provided inits full fo-rrnatto the undersighed Chief law'enforcement.officer:,or fire chief (if the v'ehicle is to be usedror.firefishtins purpos"ii "i;";h ;;i;;t jrriil6til;l;-;ffih the vehicres are to n" ur.j ut authorized emergency vehicle(s).' : None of.the'drivers, to the best of my knowledge in the last year, have been convicted of, nor servedany sentenc.gs ol periods of probation for any felonies, nor arrested and convicted of a diug or alcoholviolation or-illegal use or pos'session of drugd, nor been required to register as a sex offendir, norhave any of them been adjudicated incompltent or insane.' Only.the vehicle(s) and equipment listed in this application will be used as outlined in this application,and that only the operators listed under this perniii will drive the:vehicle(s). ff.18 qlf ]!_ !:ltut or executive officer in charge cf overseeing this permit, I understand that if the permit istssued, tt.is my responsibility to ensure: ' No drivBr listed in.this permit !?ge the vehicle for private purposes unleEs all emergency,equipment isremoVed or'covered. ' . ' .?',','' b. c- b a.i c. No driver other than those listed under this approved permit operates the vehicte(s) listed unless allemergency equipment is removed or covered.' lf I wis'h to add a new driver or veniie to this permit, Imust receive prior approval before they are authorized under this permit. tion and must obey all traffic laws. I understand that orm liability as well'as ls p9 ln addition, I unde rstand that it is my responsibil alltimes adrivers a re prege nt in dach vehicle at 'Signature Name .oR PRtNr) use the vehicle(s) and eme rgency a need continues to exist in my vehicles and that the a has the operate such eind I know of Please type or Signature Name. (Please Print) Phone Restri ction .Title, Pntt; ./unY Date listed as s described in part 2 of on for:the listed veh s to be used as authorized tn 3 of this application to denied." list of approved if requested. 7 cy The that Date ll , Jurisdictjon 3oos323-006 (R lZOe) ela^ar/ ItlAf v Sira E f,/lailt--tYtclil be Page 4 of 5 AUTHOR IZED EMERGENCY VEH IC LE PERMIT APPLICATION RENEWAL H.H"Hffi[W I certifY that a. ; Ail of the information given in,this appl'aation is correcJ to the beslof mylknowlqdgq ?ld provided in its fu1 forrnat to the undersigneo cnidt law enforcem"ni omc"r or fire'chief (if tre vehicle is,to be used for firefighting purposes) of each;ffiryl";;;;;till; ;hiih tne venicles ire to be used as authorized ernergency vehicle(s)' b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of prouaiirjn toi iny ietonies, nor inesieo and convicted of a drug or alcohol violation or illegal use or por.ur.ion- oi orrgi, nor beeh required to register as a sex offender, nor have anyof th6m been adjudicated incompetent or insane' c. only the vehiclti(s) and equipment listed in this application will be used as outlined in this application' andthat ;iy6;;p;iitoii-ib_'tuo under this permiiwill drive the vehicle(s) As the prirnary holcler or.exec.utive officer in charge of overseeing this permit, I understand that if the permit is issued, it.is my responsibility to.ensure; . a. , No drivprlisted in.this permit uses.the vehicle for pr[vate purposes unleqs all emergency.equipment is remoVed or'covered. b. No driver other than those listed under this approved permit operates the vehicle(s) ,listed, unless-all emergency equipment is removeA ;-;ot";;i.' rf r wiJh io ioo' q new driver or vehicle to this permit, I ;;;i;;;i";i;i& ilt'."""r o"t"re tn"y ar" autfrorlzg{ under this permir c. The driver must exercisg due care 9nd paution and m,ust.gbe.y all haffic laws I understand that the inappropriate or misuse of authorized emergel,cy^v^e,h',"1",?,T:y result in criminal or civil liability as well as cancellation of this permit as outlined uncler cnapter zvr+'ro vv/lv' of this permit and list of approved, law enforcement, if requested. 6. Permit Validation: ln addition, I understand th drivers are Signature Name Restrictions each (cHrEE oFFrcER) PRINT) 'Title eti Date e Gertification: This renewal application for Authorized Eme-rgency Vehicle Permits will not' be bccepted untess cERTIF1ED ov inJ ini.itilw entorcemeniotri""r or fir-e cnibf.(if the vehiclg lt-1" be used for firefighting purposes)-of each prirya.ry luti.iiciioii in *t,.n tn" vehiclis are to be used as authorized emergency vehicles (see part 4 of this appi'c;t't"i'^lf t6e a.piJcation is made by the chief of a law enforcement agency or fire department, it'rirli-dJ'c'iinFifD by ine neao of the Rofitical sub-division' The certification mult contain the following language: : 3000-323{06 (R 12109) e ioe,? i dacy I t'jA* y I i r aa Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL EEM,_W a'' ' 'All -of the informltion given in this app-lication,_is correct to the best of my knowledge and provided in its full lormat to the undersloned crriet taw enro;;;i;fri;;i;;fi; ;hl"i'i;il; vehicte is to be usedfor.firefighting purposes) of 6actr primaryjurisoictnnln wntn tne venicles are to oe uieo asauthorized ernergency vetricle(s).' b' None of the drivers, to the best of my knowledge in the last year, have been convicted ol nor servedanY sentenc,es_or q:1,"d. of probation jo1 any ielonies, nor arrested and convicted of a diug oiaiconotviolation .ljl:q..1 use or posbessio.n of drugd, noi u"eir required to r'"gistur as a sex offender, norhave any of them been ailjudicated incomp?tbnt oi inrunu.c' Only the vehicle(s) and equipment lis.ted.in this application will be used as ouflined in this application,and that only the operators listed under this perniii wiri oiive tne ;"hi;t"(r). As the. gilnarv holder or executive officer in charge of overseeing this oermit, I understand that if lhe permit isissued, it.is my responsibility to gnsure:- a' ' No drivpr li:t^*. q.tlis permit .ug9a the vehicle for private purposes'unless alt emergency,equipment isremoVed or covered. b' No driver other than those listed u.nder this apprbved perrnit operates the vehicte(s) listed unless all T:19:TI equipment is removed o, covered.'ii i *irn to add a n"* driuer or vehicte to this permit, Imust receive prior approval before they are authorized under this permit- - c' The driver must exercise due ""r" "ni caution and must obey all traffic laws. l. understand that thu-,1-1|-qPpriate or misu.se of au-thorized emergency vehicles may result in criminal or civilliability as well as cancelidtion of tnis permii ;; orflil# ,r,d!i "iupt"r 204-36 WAc. 6. Permit Validation: I certify that: ln addition, drivers are I r-rnderstand'th present iri each Signature ..-Title j'r/etr,Y Name Please type or print: Signature Name:' . ', (Please P.int) Phone Restriction (cHtEF- . (wP Date e certification: This renewal ap-plication for Authorif_ed Emergency Vehicle permits will not be bcceptedunless CERTIFIED by tfe cniertaw "nrorcerent officer or nrE ctr-i6rjif'il;;;i;ili" io u* used forlrjlgllilg purposesl of each primary .iuriiJi"i''"; i,i *ni"-n'tii" ,ini"r"" are to be used as authorizectemergency venlcles (see part 4 of this application).^U!E application is made by the chief of a lawenforcement agency .or.n19 department, iimust oej crnrlriED by the nead of ifie'pltiticat sub-division. Thecertification must contain the fbllowing tangulge: .Jurisdi'.' E-Mail 3000-323406 (R 12lO9) ete,tTa.tcf tVAf y tiraa Title p4L. Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL EEM_iusH|xcTofl SIATE PATROLWtr t' n ;i 6. Permit Validation: I certifY that: ln additioni I und erstand that it is fiY res a., Ail of the information givbn in this application !s gorre.ct to the best ot ryv, ri19-rytedgerandproviaed ln its fu1 format to the undersigned'iiiiit ilw 6nrqr*,ment otficer'or fire chief (if:the vehicle is to be used ror nrensnfii;;;;";;;i;i;";h"pii"ij*,ir'ir;Jictionln'*nich the vehicles are to be used as authorized ernergency vehicle(s)' b. None of the drivers, to the best of my knowledge in the last year, have been convicted of' nor served any sentences or periods of pronaii.in ioi anv ielonies, nor irresieo and convicted of a drug or alcohol violation or illegal use or po.r.iion oi orugr, nor ueeh required to register as a sex offender, nor have any of the-m been adjudicated incompetent or insane. c. Only the vehiclj(s) and equipment listed in this applic.ation will be used as outlined in this application' unitnrt;il ti;;p;iitoiliirt.o under this perniit will drive the vehicle(s) As the primary holder or executive officer in charge of overseeing this permit, I understand that if the permit is issued,.it.is rny lesponsibility to gnsure: . . a. , No driv.er listed in.this permit uselthe vehicle for private purposgs unleqs allemergency.equipment is remoVed or'covered' b. No driver other than those listed under this approved permit operates th.e vehicle(s) listed unless all emergency equipment is ,"mov"i'Jrtov"rel.' ril wis:n tJ ibd' a new driver or vehicle to this permit' I must receilil;i#'3"ppr;d ;;f*;ih.y aie zutnorized under this permit' rnust exercise due care and caution and must obey alltraffic laws. I understand that the inappropriate or misuse of authorizeO ptqlggll"#^*Ltl",?,T:y result in eriminal or civil ii"6if iiy L" *eit as caniefieition of this per:mit as outlined under chapter 204'36 WAU, to ensure'that a copy of this permit and li-st of approved I . '''iuiin"-pi*Lnt"o to law enforcement, if requested' i, drivers are present id each vehicle at all ponsibility times and ''Signature Name Restrictions (cHrEF Date oR PRINI ls will not be'accePted7. Certification: This renewalapplication forAuthorized Emeroencv Vehicle Permil il;;; cEniirieo by the chief taw "nior"urnunioni""r or fir6 ctiibt 1it tne vehicle is to be used for firefighting purposes) of each p1q?.ry;;;Ji;i6; in *nicn tn" veniCris Jre to be used as authorized emergency vehictes (see part + ot tnis'ap-pi;"'ail;i. ff t# ippri""tion is made by the chief of a law enforcement agency or fire oepartmeniiiiti,ii 6J'cEnlFiio u}, irre nJao of the political sub'division' The iJrtinlation mfst cdntain the fbllowing language: sOOO-323406 (R 1ZO9) Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PER MIT APPLICATION REN EWAL (cHlEF ,Title oEFtcER) Date e OR PRINT) 0 Sr€sN$ 0R.srq,\.l4L flLWuFTrE ipt'tc€S. o 6. Permit Validation: I certify that: iri each Signature Name a' All of the information given in this app-lication is correc! to-lhe best of my knowledge and provided inits full formatto the unoersiqn;o ch'idf la; ;;r*""r"rt o.{cgr or fire chief (if the vehicle is to be usedfor firefighting p;,p*;;i;i'""u"n prir"t j*ffi.;iln in wnicn the vehictes are to be used asauthorized ernergbncy vehicle(s)., ' "-'r rt'|'vy'v'I'|v,r b' None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor servedany sentences or periods of probation 1or inlrLionies, nor arrested and convicted of a drug or alcoholviolation or illegal 'use or posiessio.n ororug3, n-oi'oJ.n required to register as a sex offender, norhave any of them been abjuoicated incomp?,iLnioiinr"n".c 3,{X1H?Ji,}'?l"i'JrT:;tr1ffi:'1ffi:?ift15,.;5i,[:fg?Jijj3;"H:,i,-xi ou'ined in this app,ication, As the orimary holder or executive officer in charge of overseeing this permit, I understand that if the permit isrssued, it.is my responsibility to gnslie:-. .a' ' No drivprlisted in this permit useq the vehicle fol private purposes'unqess alt emergencyrEuipment isremoVed or'covered. ' . b' No driver other than those listed under this approved permit operates the vehicle(s) listed unless allernergency equipment is remoieo or cov"id."iii*'i.n to ioo-i new diiu"io,. vehicre tothis permit, rmust receive prior approvar before tney aie autnbliiii under this permit.c' The driver rnust exercise due care and caution and must obey all traffic laws. I understand that tn"-'l-1P!looriate or misuse of au.thorized emergency-vehicles may result in criminal or civilliabilitv as wet "" ""nceriJt6;;;;l#rilit ". ourined underchapter 204-g6wAc. : . , ln addition, drivers are l understand th 7 certification: This renewalapplication "ltlr!."1,::d Emergencyte_hicte permits wiil not be bcceptedunless cERTIFIED by tle cnier riw en'ft'rlement oniceroiiirE "r,i"r 6rtnu vehicte is to be usedfor:firefighting PurPoses) of-{9! n1iry.;,w'jl,iiro.i.tio'i in *[cn't'riJu"uni"ru, are to be used as authorizecjemergencv vehicles (see part 4 ot tniiiooiicitro;tr'J11!'g.o1lft"tion is made by the chief of a 6wenforcement agencv or fitb o"pattm"nilt"rrrt u,j cenTlFiio-by the head of the political sub-division. Thecertifi cation m ust conta in tn e tbf lowin g'l'* g u" g", S000-323{06 (R 12109) Page 4 of 5 6. PermitValidation: gCT *5 201i I certify that ffit,, a. Att of the information given in this application is correct to the best of ffftr*,*ge and ffovided in its full format to the undersigned chidf law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes) of -each primary jurisdiction in.which the vehicles are to be used as authorized ernbrgbncy veh icle(s). b. None of the drivers, to the best of my knowledge in the last year, have been convicted ol nor served any sentences or periods of probatidn for any ielonies, nor drrested and convicted of a-drug or alcohol violation or illegal use or pos'session of drugs, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane' c. Only the vehichd(s) and equipment listed in this application will be used as outlined in this application, andthat only the-6peratorb listed under this permit will drive the vehicle(s). AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL As the primary holder or executive officer in charge of overseeing this permit, I understand that if the permit is issued, it.is my responsibility to gnsure; a. . No drivpr listed in,this permit uses, the vehicle foq private purposes unleEs all emgrgency.equipment is remoVed 6r'cbvered. ' b. No driver other than those listed under this apprbved peimit operates the vehicle(s) .listed unless all . emergency equipment is removed or covereil.' lf I wis'h to add' a new driver or vehicle to this permit, I mustieceive irribr approval before they are authorized under this permit. c. The driver must exercise due care and cautien and:must obey all traffic laws, I understand that the inappropriate or liability as well as cancelidtion of this misuse of autherized emergency vehicles'may per,mit as' outlined under'chapter 204-36 WACj result ln addition, I understand th at it is my responsibility to ensure that a coPY listrof approved'' drivers are present iri each veh icle at alltimes and must be presented to if requested ... t : Signature'..Title (cHrEF. Name Date .oR PRrNT) t ( i 7 Certification: This renewal application for Authorized Emergency Vetricle Permits will.not be accepted uniess CERTIFIED by the chidf law enfcrcement officer or fire cliie f (if the vehicle is to be used fot' firenghting'purposes)'of each primary jurisdiction in which the vehicles are to be used as authorized emeigeniyveiricles isee part 4 of this application). lf the app,lication is ma.de-p.y the .chief of alaw enfordement agency'oinrb Oepartment, it must bd CERTIFieO Oy the head of the political sub-division:' The certification must contain the following language: "! hereby, certifv that I have reviewed this entire appliqation;.that I am aware that the ap_plicantintends to . .. use tne'"EE@l ind emergency equipment listed as speciiically described in pa$ 2_of this application; that a need continuds to exist in iry ltiriscliciion for the listed Vdhicles to be used as authorized emergency venlctes and that the applicanf has the appropriate authority as described in. part 3. of.this.application to . op"i'it" "u"n Ar''pm#d; "nO i r,now ot rio reison why this'application should be denied.'] Please type or print: Signature Date /3:4rgs1,Titl,e Name (Please Print) Phone Restri Jurisdiction E-Mafi: 3000-323{06 (R tZ09) e'L &t- Page 4 of 5 AUTHORIZED EMERGEN CY VEHICLE PERMIT RENEWALAPPLICATION 6. PermitValidation: I certify that: OR PRINT) Certification: This n$i$***#ffi g1,;gj,l,nltpfi r+[*_'$'m,,,,f]:,ffi 'l#,l,$!:i,ffi ',,"ernergency vehicles :il.,;::T":il"xxl:.J, ta 300&323{06 (R 1zo9)Lra.^rrs c:€g,raet- Cfi1OA qsD l@-'c,^^ AUTHORIZED EMERGENCY VEHIC LE PERMIT APPLICATION RENEWAL H.RgffiWT 6. Permit Validation: I certify that: a Please type or print: Signature :, Name (Please Priot)' Phone Restrictions Date Jurisdiction E-Mail b c. All of the information given.in this application is correct to the best of my knowledge and provided inits full format to the undersigned chief law enforcernent officei cir fire chief (if the v-ehicle is to be used for firefighting purposes) of -each primary jurisdiction in which the vehicles ire to be used as authorized ernergency vehicle(s). None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor servedany sentenc.es or periods of probation for any felonies, nor drrested and convicted of a drug or alcoholviolation orillegal use or possession of drugd, nor been required to register as a sex offend-er, norhave any of them been adjudicated incomp-etent or insane.' Only.the vehicle(s) and -equipment listed in this application will be used as outlined in this application,and that only the operatois listed under this perniiiwill drive the vehicle(s). As the P|iinafv holder or executive officer in charge of overseeing this permit, I understand that if the perrnit isissued, it.is my responsibility to ensure: a. , No d1ive1 listed i.p th.is permit uses" the vehicle fo1 private purposes unless all emergency.equipment isremoVed or'covered. . b. No driver other than those listed under this apprbved peimit operates the vehicle(s) listed unless allemergency equipment is removed or covered.' lf I wish to add'a new driver or vehi6te to this permit, Imust receive prior approval before they are authorized uhder this permit. c. The driver must exercise due care and caution and must obey all traffic laws. I understand that the inappropriate or misuse of authorized emergency vehicles may result in criminalor civilliability as wellas cancelidtion of this permiid"rtil;J-;.deitnipilTzb;:b-6-wAc: '--"" "' -""""-: responsibility to ensure that a copy of this permit and list of approved all times and must be presented to law enforcement, if requested. , i., ., Signature ,,,Tifle Name Date .oR PR|NT) 7 Gertification: This relgwal ap_plication for Authorized Emergency Vehicle permits will not be bcceptedunless CERTIFIED by $e'chief law enforcement officer or fir6 cnibf (if the vehicte is to be used for ' firefighting purposes) of each primary jurisdiction in which the vehiclds are to be used as authoriied emergency vehicles (se9 part 4 of this application). lf the application is made by the chief of a lawenforcement agency 9r.fir9 department, if must Od Ce nlfiED by the head of the political sub-division. Thecertification must contain the following language: "l hereby c,q4ify that I have reviewed this entire application;.that I am aware that the applicant iniends to use the vehicle(s).and emergency equipment listed'as speciiically described in part Z df ttris applicdtion; thaia need continues lo exist.in my.jurisdiciion for the listed Vdhicles io be used as iuthorized emiigency ' vehicles and that the applicant has the appropriate authority as described in part 3 of this applicitionio .operate such equipment; and I know of rio reison why this -application should be denied." ',' 3000-323406 (R 12109)06Oo ro 0f0o tte Fm ro /Qrltj Title Pana A al R AUTHOR IZED EMERGENCY VEHI CLE PERMIT APPLICATION R ENEWAL Date .9R FRtr.f!) o6. Permit Validation: I certify that: a' All of the information given in this app,lication js correc-i to.lh" best of my knowledge and provided inits rull rormat to 11e uriugislg;'Jo .niJr iil ;;6;;#;i;rfi;;r-;;; .niu?'tit the vehicre is to be usedfor firefighting purposesi "l"ur.n ili',,y j;;ii.t'"Llii=i, which the venicres are to be used asa uthorized emergbncy jun irf uGl.b' None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor servedany sentenc..es or periods or prtu"ti,in Fi ;;v i#ni"r, nor. arrested and convicted of a drug or alcoholX:1l3''3,l,iil',fffi;:r:n:ri,U{**'-arf;:m:uired to resisteras a sexonenoli noic 3,{Xilx?J;,}'?l"J'i,??:,:trp,[:'jffi:?1;i1fffp*",fix;lJillff"Hffi o,,,,n"d in this apprication, t:J3: ii'is#, i::iil:t?,fii$:;,?T::er i' charsl ",;";"",;s rhis permi, ; ;",.,"nd that ir ihe permit is a' ' l:tti:tJjf:"bt$j!:" permit uses" tne verricte ror private purposes'unless arr emergency.equipment is ,ll'.\u^\\:., "f- ^L:\r)\l 7' certification: This-renewalapplication forAuthorized rmergency.yg,hple permits willnot be bcceotedunless cERT|FlEll Qt' tl'u tniJrii* ii-'ro,cemeniiFil;;;r" chief (if gre vehicre is ro be used for ,iireiighiing purposes; or ""lrr i,:riiliri'iuriso.iciio,i iri',iii"i'tire .venicris are to oJ used as aurhorizeciemergencv vehicles (see part4;iii'is:,"pptd;ii";i. iliilJlp_lication is made oyirre chief of a raw::fif;::iltTiitii'J,ii'l',"#"d,ffi,Tt;Tfi[,*?J"'iftiFLo bv the head or the poriticar sub-division rhe (Please print) ,. Phone Res trictions Jurisd E-Mail L^/1 6'\ G"a,+/s /LMli 3000-323€06 (R 12109) aJ -:.-+c.Ifus ZJL- I t. AA,r' t_./4 t-J Page 4 of S t CFIIIISTINE CI. CRECOCRE 6oveynor Mr. Steven Bartel Washington State Motorcade 4409 SW Admiral#102 Seattle WA 981l6 STATE OF l&/ASHt FJCTOi\ WASI*I I NCTON STATE PATRCI- ceneral Adrninistration Euilding e Fo $ox f2600 e olympEa, wA 98504-260$ * (360) 596-4000 c www.wsp.r,va.gov January 6,2012 RHCffi}VHM JAN X 2 REC',D P#ffiCfr MFFr+RTMffi VIN llIDtFMNl38B628833 lnDlFHMl5C8609290 License Plate 284224 5B8678 Registered Owner Randy Hodges Don Huiaft l$ltN R. &ATSSTE Chief Dear Mr. Bartel: This letter is a second response to the amelded renewal application received by this office for thewashington State Motorcade Authorized Fmergeily Vetr$G-iermit. rrre auinoii;J E;,il;,',vehicle Permit issued to the washington state filoitir.."g. "rpi1"a on November g, 201 L The TemporaryAuthorized Emeraency Vehicle Penn'its issued to wr;hi"d;;'stut" Motorcade for additional vehiclesIisted on your t"nEwuiuppii"ution .;;i;; on n"".rL-", il,-iitt. A letter dated November I 7,2011 was sent to you denying your initial renewal application and outlininethe additional information necessary in ordert6 p6;;!;h?"rir*ur "rv"r, p.rr'ii"ffir"ffi;;;l:;""".notified y99 tlat effective twenty days from the hate "iflri; i"ttrt your [".-it to op"rate would becancelled if all the requirement docurnentation *ur noii"""i*J uito at that time ail .rn"rg"n.y vehicleequipment must be removed and if you wish to reiniiuie vt";*-a-eVf yo-" ;;;1J LJiequireo to gothrough the applicarion process again as outrineo in-Ctadti, ioq-za wAC. The amended renewal application was received by this office on December 16,Z[lL with the followingamendments: l ' Geographic Areas. - Signatures were included for Kent, Bothell and Tukwila police departments and DistriciS of the Washington siate patror with the Siate Routes andInterstates clarified to pertain to. only waitrington Stut" put ol oiriri"lrl , 2, 7 and g.2' vehicles- Inspection iaperwork wis provide? roitrtr zoli H;i;t;;lson owned by- yourself (Steven Bartel).- 3 ' Operators - Pete Noetzel and Chris Wood were removed from the permit. However, the following information which remains in your renewal application is not authorized: I ' Geographic Areas - No certification was provided from the following jurisdictions whichremained in your renewal application:o The cities of Lake Forrest Park, Tacoma, Fife, Issaquah, Kirkland, Seattle and Sumner.. King, Skagit and Kitsap Counties. 2' Vehicles - The following vehicles listed on your renewal application have not been approved foruse: Temporary permits were sent with the letter on_November 16,2011 to allow for these vehicles toinstall:melryqcy-equipment for jhe purpoylorinspecitn.-iti"i"tnporary permits expired onDecember 16,201I and no Certificationof Emerge'nrv Eq"ip-"nt was received for eithervehicle, but both vehicles are stil lisred on tne refiewJl ffiriiJi"r. 6"ffiE",a *nt Page2 Mr. Bartel January 6,2072 S 3' operators : Don Huiatt and Earl Radford have not been approved to operate under your permitand are still listed on your renewal "ppti""ti* Therefore, this letter is formallotification that- the washington State Motorcade amended renewalapplication for an Authorized Emerge-ncyJehicd pe;-i;1tEVb.; to operai" *itr, .,n"rg"ncy lighting andsiren is denied. The permit issued t6 wishington St#-iil,tJr;;r expired on November g. 201I asindicated in the November 17'h lette; uno Ir th"erefore can""ii"i ""0 u.ilo, irr" ,""""iiltj'"it?v'.'rllgvpis based on the exniration.o{ygu1 cunent aevp u"J thi;;iil";irot receiving a complete renewalapplication as preic'ibed i;VAa ti,?-ii-o: o. f;|ffi::""ffilf;'1a,s,,"*ot,"d and is cancelted, please remove all emergency vehicte equipmenr from the equipment u, outrin.fi'nt$/f,,ll;Bill?"i,fsre-appried and G;;p-t;;;";;; 6#' *rtr' "'*ie*& As outlined in wAC /94:q-97.9 (enclosed) you do have the right to be heard within the twenty-dayperiod. Ptease conract Ms. Melissavan cci'i.o.;; it;d);t;-?'or/iivou d";;il;;estions. J and Relations JGB:mvg Enclosurecc: ChiefKathyAtwood, Everettpolice Department, !fie{Jim Collyer, puyallup police Department llie{At Compaa:r, Edmonds police Department Chief Carol Cummings, Bothell police Department Captain Jeff DeVere,birtri"t I - Tacoma chief Jon Fehlman, Bainbridge Island police Department Captain Ken Ginnard, District 2 _ Bellevue 9li"{e"ay Hwang, Federal Way police Deparrment Chief Steven Jensen, Lynwood police Department Captain Bob Johnson, District g - Bremerton Chief Bob Lee, Auburn police Department Sheriff John Lovick, Snohomish County Sheriffs Office Chief Kevin Milosevich, Renton police Department Sheriff Paul Pastor, pierce County Sheriffs Office Chief Linda piilo, beilevue potic! D;il;;;'-- Captain Jeff Sass, District 7 _ Marysville ;Chief Ken Thomas, Kent police Dipartment Ms' Melissa van Gorkom, Equipment and standards Review UnitChief Michael Villa, Tukwila potice Department Chief Greg Wilson, Mountlake Terrace irolice Department Chief Jim Zoll, Enumclaw police Department Dear Chief of Police/Sheriff: Washington State Motorcade, Inc. is currently in the process. of renewing our motor escof permit as issued by the Washinlton State patol. Each year our renewal application is required to be certified by the chief law enforcement officer of each jurisdiction in which we operate. . In past years we visited each jurisdiction in person t9 rravg.the qermit application signed, however, we frequently experienced difficulty ittting into each chieis schedule. Therefore, we are attempting to deliver them by mail in order to minimize the impict on your calendar. This will allow you to si$r the application at your convenience rather than ours. The permit application that is enclosed includes all of the applicable information. Please sign the permitand retum it (you only need retum the sheet with your sigrrature) so we can forward it to the State Patrol. If possible, please mail this as soon as your schedule p"..nitr .o *e "un have them submitted to WSP by the end of October' To assist you in completing this application, I would like to provide you with so1g-b-ackeround information about our organization. oui org;ization employs only the most experienced and most highly trained riders' Our haining program is the most "om"preh"nrive in'the industry and requires-training in safe escorting procedure-s, asupervised appienticeship program, and an advanced motorcycle operator's course instructed by CJTC certified instructors' Nearly all of our op"io., are either professionai police officers or professional fire!€hters who are certified in emergency vehicle operation. washington State Motorcade maintains two million dollars in professional liability irrru.Irr"". tf you have any questions rJgarding this application or would like to see us in person, please feel free to call me directly at206-932-3870' Respectfrrlly, Steven Bartel President Washington State Motorcade, Inc. 4409 SW Admiral #102 Seattle, WA 98116 206-361-2221 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL mmm,-FisI-nciffiEiriEffF6IWtr WASHINGTON STATE PATROL EQUIPMENT & STANDARDS REVIEW UNIT GENERAL ADMINISTMTION BLDG PO BOX 42600 OLYMP|A WA 98504-2600 DATE APPROVED: VALID UNTIL: CAPTAIN (For Department Use Only) This application must be submitted by the Chief Executive of the firm or corporation making application Please type or print in ink. Person, Company, Department, or Agency (if a person, must list agency/department representing) Address City State tJr*zip ?Bza Phone ( ze( ) ?, L. 3 lFe E-mail Vehicle lnformation: List allvehicles being used as authorized emergency vehicles. For each vehicle, provide both the vehicle and emergency equipment information as outlined below. Any new vehides-or vehicles with equipment installed olherihan what is authorized on the current permit for that vehicl+-must receive prior approval before being utilized under this permit' 1 YEAR 7oil e.B,/e,71 LICENSE NO t t*DlF$FtUBe62ot17 MODEL FLHPI MAKE H+b 1 REGISTERED OU/NER |fouc4 I *efa I SIREN [f r-nure coLoR(s) LAMP MAKE/MODEL Vl L€D A' OTHER EQUIPMENT: or" /orley F L ftP MA YEAR 2oa MODEL 64 . LICENSE NO: /H4 FHH/ gqys s? oB ? neqsEneobwrue n Croil /y'.^ot"r VIN2. oSIREN zete rlLLAMP COLOR(S) MAKSMODEL OTHER EQUIPMENT: 3000-323{06 (R t2l09)Page 1 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL EEN,_wASffiGTOffiTE PATROLWDT VEHICLE INFORMATION c. YEAR LLtcEtL ENSE NO 2oo7 ? 37v MAKE MODELH*/.7 tL HP VIN I FHn REGISTERED ER X"At H ry.rt EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL $r srnrru u/t e /c n lsDz, o p ffi L,+ne coLoR(s) LAMP MAKE/MODEL uJAe,(ca 0 cTtF 1 OTHER EQUIPMENT: VEHIC LE INFORMATION't. 4. YEAR LICENSE NO. MAKE MODEL VIN REGISTERED OWNER EQUIPMENT INFORMATION ..,:.,. ': MAKE MODEL SIREN I lnrvrn coloR(s) LAMP MAKE/MODEL OTHER EQUIPMENT: SIREN I r-nrvrr COLOR(S) LAMP MAKE/MODEL fl orurn EeurPMENr trltztFtlp tSOg,cz REG]STERED OWNER rt an,& //e o(o.s VIN g e33 H 17#e MODEL YEAR A btz LICENSE NO, AB Vzzy 6. YEAR 20/z LICENSE NO sB sc 76 MAKE MODEL /n4'y VIN t tlprFtA t.t <F6o?27e REGISTERED OWNER Drn H,c; oZ/ Note: This page may be copied if additional vehicles need to be added to the permii. nny additional sheets attached must provide the vehicle and equipment information in the same format as above. SIREN coLoR(s) MAKEiMODEL OTHER EQUIPMENT: 3000-323-006 (R 12/09)Page 2 of 5 H.F*"HMWtr purpose of Application: Describe the specific purpose for which the vehicle(s) shall be used as authorized emeigency vehicle(s) anO whainGssitates the vehicles' registi'ation as emergency vehicles Explain the natuie rn'd ""op" ofihe duties, responsibility, and intended use of emergency equiprnent' Geographic Area: Check which types of roads you will be operating on and state the specific geographic area(-sy in which the vehicles shall -be used as auihorized emergency vehicles (city, county, etc.)' (Certification from. each primary jurisdiction is required under part 7 of this application.) AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL To escerf f ,ortrJ 5sr-icc! Authority: Explain authority outlined under statute (Revised Code of Washington) that allows the vehicles' operatori to use emetgency equipment for the purpose outlined under part 2 of this application. 2 2 4 5 n City Streets (list all cities),{ tr County Roads (list a ll counties) State Routes/l nte rstates JE t Z ?q. Z {ot/ -r, ol ^r zat ?r r r..ro ?t f/ 8t ?/ or t I n S / + -r/ >r Operators: please list all drivers that you intend to have operating the vehicle(s) listed in this application and indicate whether or not the operator/driver is new since your last application. (Use additional sh'eet if necess ary) tl, - fn.tlc- fqftSc' of f co* < raf egcorf3 uti*1 ur'c,r^; ^, Aevi 6.c 5 4! f ro ei "tc.l i,, RCu '/C,' n l?0/16' '7 6 7O a*tlzorizel e-^.1 occflinc.( in fl;s fcrr+if- 45 OPERATOR/DRIVER NEW TbpiRnroRvontVen NEw OPERATOR/DRIVER NEW ! tr tr ! tr tr ! tr tr n D tr n n n tr ! n tr n tr 3@0-323-006 (R 12109) Page 3 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL tsEm.-w^sfficjffitE P TROTWDT 6. Permit Validation: I certify that: a. All of the information given in this application is correct to the best of my knowledge and provided in its full format to the undersigned chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes) of each primary jurisdiction in which the vehicles are to be used as authorized ernergency veh icle(s). b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offend-er, nor have any of them been adjudicated incompetent or insane. c. Only the vehiclei(s) and equipment listed in this application will be used as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the primary holder or executive officer in charge of overseeing this permit, I understand that if the permit is issued, it is my responsibility to ensure: a. , No driv.er listed in.this permit u9es. lhe vehicle for private purposes unleQs all emergency.equipment is remoVed or'covered. b. No driver other than those listed under this apprbved permit operates the vehicle(s) listed unless all emergency equipment is removed or covered. lf I wish to add a new driver or vehicle to this permit, I must receive prior approval before they are authorized under this permit. c. The driver must exercise due care and caution and must obey alltraffic laws. I understand that the inappropriate or misuse of authorized emergency vehicles may result in criminal or civil liability as well as cancellation of this permit as outlined under cn-pteiZO+-36 WAC: ln addition, drivers are I understand that it is my responsibility present in each vehicle at alltimes and (cHtEF to ensure that a copy of this permit and list of approved must be presented to law enforcement, if requested. Title Date Signature Name 7 Please type or Signature Name (Please Print) Phone 5*eue z Po.rfu/ IrYPE OR PRINT) Certification: This renewal application for Authorized Emergency Vehicle Permits will not be bccepted uniess CERTIFIED by the chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes) of each primary jurisdiction in which the vehicles are to be used as authorized emergency vehicles (see part 4 of this application). lf the application is made by the chief of a law enforcement agency or fire department, it must be CERTIFIED by the head of the political sub-division. The certification must contain the following language: "l hereby certifv that I have reviewed this entire application;.that I am aware that the applicant intends to 6f tnis application; thatuse the vehicle(s) and emergency equipment listed as specifically described in part 2 a need continues to exist urisdiction for the listed vdhicles to be used as authorized emergency vehicles and that the appl as the appropriate authority as described in part 3 of this application to operate such nt; and I know of no reason why this application should be denied.' rn myJ icant h W'{,y hue Date ll Jurisdiction 3OOG.323OO6 (R 12109) e r+c*laaay tttAf v !irc,r E-Mail Page 4 of 5 Restrictions C5-{RISTINE O. CRECOIRE Coverncr Ceneral Addninistrhtion B ,ohrN R. BATISTE Chief WAS.H I NCTON' STATE. PATROI' : WA 9B504-26-00 .(3q!) 75E-6549 : November 23,2010 Mr. Steven Bartel Washington State Motorcade 4409 SW Admiral #102 Seattle WA 98116 Dear Mr. Badel: The renewed Authorized Emergency Vehicle Permit (AEVP) for the vehicles used by Washington State Motorcade is enclosed. Please ensure a copy of the permit and a list of apprJved drivers are carried in each vehicle at all times. Please note that you have only been approved to operqtg on City Streets ?nd County roads listed ;n 161i peimit. "in order'to:be'authori2bO to operate on any'other city street, county road, State Route or lnte,r:statq you listed"inyour.-rep'ewal application, you will need to gain authorization from each of those jur.is$!glioqrs.l lf additional signatures are fonrvarded to our office your application will be revised to include those geographic areas approved at that time. ln addition, you are only approved to use a signal preemption device in,the citie.s of Mountlake'Terrace and gnumclaw. Use of a signal preemption device in any other location is not authorized by this permit. Also enclosed are the Vehicle Permit for the new vehicles which have been added to the list of vehicles approved for use under the Washington State Motorcade Authorized Emergency Vehiile Permit (AEVP). A.copy of the vehicle permit, current AEVP, and list of approved drivers must be carried in the vehicle at all times. Please note that Mr. Huiatt and Mr. Chiswell are not an approved operators under your permit. Only the approved drivers listed on your permit may operate this vehicle, Therefore Mr. Huiatt and Mr. Chiswell may not operate any vehicle with the emergency equipment. lf Mr. Huiatt and Mr. Chisweliwish to operate their vehicles, the emergency lighting would either need to be removed, or they would need to go throdgh the process to aOO nim to your permit. Enclosed are some fingerprint cards, if you wish to start this process please return these cards along with the $45.25 processing fee to our office: Washington State Patrol EquiPment and Standards Unit PO Box 42600 Olympia WA 98504-2600 R*Ercr*E 5#E=D Nov 2l 20t$ KEIff POTICE DEPARTMENT !F*Itp Mr, Steven Bartel November 23,2010 Page2 lf approved you will receive a letter stating that Mr. Huiatt and Mr. Chiswell have been added to your permit, and only at that time could Mr. Huiatt and Mr. Chiswell be allowed to operate these vehicles with emergency equipment installed. Approximately one month prior to the expiration date, a renewalform will be sent to you. lf you have any questions please call Ms. Melissa Van Gorkom at (360) 596-4017 Sin Ca G ment a G. nd Relations n JGB:mvg' Enclosuie cc: Ms. Melissa Van Gorkom, Equipment and Standards Captain Steve Burns, District 2 - Bellevue Chief A.D. Compaan, Edmonds Police Department Captain Jeff DeVere, District 1 - Tacoma Chief Jon Fehlman, Bainbridge lsland Police Department Captain Ken Ginnard, District 7 - Marysville Chief Andy Hwang, Federal Way Police Department Chief Steven Jensen, Lynwood Police Department Chief Robert Lee, Auburn Police Department Sheriff Paul Pastor, Pierce County Sheriffs Otfice Chief Linda Pillo, Bellevue Police Department hief Jim Scharf, Everett Police Chief Jim Zoll, Enumclaw Police Department AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H,R.HMWtr WASH INGTON STATE PATROL EQUIPMENT & STANDARDS REVIEW UNIT GENERAL ADMINISTRATION BI.DG PO BOX 42600 OLYMPTA WA 98504-260q Please type or print in ink. Person, Company, Department, or Agency (if a person, must list agency/department representing) Address Ucl O q f tl Ff ,,1,,.i.*af 1Ft O'>. DATEAPPROVED:November 23, 2010 VALID UNTIL:N em er 11 CAPTAIN or Use Only) e This application must be submitted by the Chief Executive of the firm or corporation making application. City State L/t+zip 7R//6 Phone (Zaa ) f<z.ZS'fa E-mail Sf/"*fe-/ A.oct ? @ v,zl",;r. roir^T 1. Vehicle lnformation: List all vehicles being used as authorized emergency vehicles. For each vehicle, provide both the vehicle and emergency equipment information as outlined below. Any new vehicles-or vehicles with equipment installed other than what is authorized on the current permit for that vehicle-must r;ceive prior approval before being utilized under this permit. OTHER EQUIPMENT: . ... . VEHIC-LE IN.FORMATION YEAR /oio LICENSE NO 8* q etq MODELMAKE VIN R OWNER s' LAMP COLOR(S) LAMP MAKE/MODEL VEHICLE INFORMATION Le .&t YEAR LICENSE NO f€?6Tail t/*,/e v /Zf/ fP MAKE MODEL VIN R ISTER D OWNER EMERGENCY EQUIPMENT INFORMATION INSTALLED MAKE MODEL SIREN lrz e LAMP COLOR(S) LAMP MAKE/MODEL OTHER EQUIPMENT: 3000-323-006 (05/09)Page 1 of 5 AUTHORIZED EMERGENCY VEHIC LE PERMIT.APPLICATION RENEWAL tlllrLtr rN TIONFORMA VIN ED MOD LAMP LAMP COLOR(S) Note: This page may attached mustirovide OTHER EQUIPMENT: OTHER EQUIPMENT: OTHER EQUIPMENT: OTHER EQUIPMENT:. additionalvehicles need to be added to and equ ipment information in the same additional sheets /, LAMP COLOR(S) LAMP LICENSE NO.YEAR MODELMAKE LAMP coLoR(s) SIREN 3000-323_006 (os/oe) '. page 2 ofS : .. I AUTHORIZED EMERGENCY VEHICLE PERMIT H.,r!l*J#ffiWtrATION RENEWAL 2. Purpose of Application: Describe the specific purpose for which the vehicle(s) shall be used as Explain authority ed under (Revised hington) that allows the veh 4. Geographic Area: Check which types of roads you will be operating on and state the specific geographic area(s) in which the vehicles shall be used as authorized emergency vehicles (city, county, etc.). (Certification from each primqry jurisdiction is required under part 7 of this application.) | ','| ' : C) f"r{4e.yrt7/e5e- ",f f*ae-pulAScor.t'}uti*4 t'ualt4i"y cfe *ic-t1 a. t 7ro*:de./ ; "t tlCu/ "/6.7?. i?.y' ri6,2 E tfA ,z! ce ut4cyi'zenl c-"t onf/,'n-,/ ,;^ 71)s f *.on,-t t .t F ."v ,$" (L! 1i t: ; ,' \- ^\'i County Roads (list all coUnties) State Routes/lnterstates 5. Operbtors: Please list all drivers that you intend to have operating the vehicle(s) listed in this application the operator/driver is new since your last application .-. (Us,e if OPERATOR/DR|VER : N.EW.I n D n D u D n tr tr tr tr D tr F 3000-323-006 (05/09)Page 3 of 5 i AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL EEM_W- 6. Permit Validation: , I certify that:,i a' All of the information given in this app-lication is correct to-the best of my knowledge and provided inits full format'to the uridersigned cnidf taw enrorcemlnt omcer,or fire chief (if the vehicle is to be usedfor.firefighting purposes) of 6ach pr:imary juriiJi.tlon-in which the vehicles are to be used asauthorized ernergency vehicle(s). b' None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor servedany sentences or periods of probation fo.r any ietoniJs, nor arrested and convicted of a drug or alcoholviolation or illegal use or posiessio.n of drugJ, noi u"un required to register as a sex offender, norhave any of rhem been aoludicateo incomplllnioiinr"ne. c' Only the vehicle(s) and equipment listed..in this application will be used as ouilined in this application,and that onlv the operatorb listed under th's teriliiwitta;iu" iil;uhiil(r) ' As the primary holder or,e;Bcutive officer in charge of overseeing this permit, l undei3tand that if ihe permit is' ". .issued, it is my responsibility to ensure: a' No driver listed in this permit uses the vehicle for private purposes unless all emergency equipment isremoved or covered. ' '- r -'r --vv b' No driver other than ihose listed under this approved permit operates the vehicle(s) listed unless allemergency equipment is removed or covereil.' lf I wis'h to aoo j new d;ilu;r venii;re io inii perrrut, rrnust receive prior approval before they are authoriied unGrlnir p"r,i'ii. -' c' The driver must exercise due care and caution and must obey all traffic laws. I understand that the-inappropriate or misuse of authorized emergency-vehicles may result in criminal or civilliability as well as cancelidtion of this p.rmit as ouflineo-uno-i cnapter 204-36WAc. ln addition' I understand that it is.my re.sponsibility. to ensure that a copy of this'permit and list of approveddrivers are present in each vehicle at attiimes anb rurioe presented'tb nw en?oicement, if requested. Signature Name (cHtEF oFFrcER) iy'e-* Title Date (TYPE OR PRINT) 7 Please type or Sign Name (Please Print) Phone certification: This renewalap-plication forAuthorized EmergencyVe-hicle permits will not be acceptedunless cERTIFIED !v tl,e chidtlaw enforcement officer or firE cni6t 1ir tne venici;'i" i; be used forlt:lglltg purposesfof each. primary-luriidiction in *nicn tneluehictes are to be used as aurhorizedemergency vehicles (see part 4 of this application)._lf the appticition i. r"A;Eli6ini"r of a tawenforcement agency 9r.ni| department, it'must nei cEnlrieo oy tne neid or tfie'potiticat sub-division. Thecertification must contain the fbllowing ianguage: that Date Jurisdiction E-Mail( i-'} s-Ll o " 5b 03 {S5{-:.l";{rrfi g,' lgnnuu;$cl utcr' it S 3000-323-006 (05/oe) RES TRr cTr o NS: cannot operate wit.h a signal preernpLio" pagvtdd. AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL EEM/_wrsilGtox ilTE P|lRoLWDtr 6. Permit Validation: I certify that: All of the information given in this application is correct to the best of my knowledge and provided in 1 its full foimatto the undersigned ch,ief law enforcement officer or fire chief (if the'vehicle'isto be used for firefighting purposes) of each primary iurisdiction in which the vehicles are to be used as authorizld eirbrgbncy vehicle(s).' None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane. Only the vehicle(s) and equipment listed in this application will be used as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the prirnary holder orexecutive officer in charge of overseeingithis permit, I issued, it is my a. Nod uses the vehicle for private purposes unless allemergency equipment is Please type or a. b. c. t e removed or covered. b. No driver other than those listed under this approved permit operates the vehicle(s) listed unless all emergency equipment is removed or covered. lf I wish to add a neW driver or vehicle to this permit, I must receive prior approval before they are authorized under this permit. c. The driver must exercise due care and caution. and must obey all traffic laws. I understand that the inappropriate or misuse of authorized emergency vehicles,may result in criminal or civil liability as well as canceliation of this permit as outlined under chapter 204-36 WAC. '. : ln addition, I understand that it is my, responsibility to ensure that a copy of this permit and list of ?pprovsd ' " '' ; drivers are present in each vehicle at all times and must beqplesg;'rted to law enforcement; if r:equested,: : ' ' I Signature Titte Fa-,, ,;,J* -'? (cHrEF oFFrcER) Name SYeiten Ba-nft-/Date (TYPE OR PRINT) 7 Certification: This renewal application for Authorized Emergency Vehicle Permits will not be accepted unless CERTIFIED by the chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes) of each primary jurisdiction in which the vehicles are to be usecj as authorized emeigenCy vehicles (see part 4 of this application). lf the application is made by the chief of a law enforcement agency or fird department, it must be CERTIFIED by the head of the political sub-division. The certification must contain the following language: "l hereby certifv that I have reviewed this entire application; that I am aware that the applicant intends to . use the vefricte6l and emergency equipment listed as specifically described in part 2 of this application; that a need continues to exist in my jurisdiction for the listed vehicles to be used as authorized emergency vehicles and that the applicant has the appropriate authority as described in part 3 of.this application to operate such equipment; and I know,of no,reason why this application should be denied." Signatu Name (Please Prinl) Phone 'rlt{'-'t?toJ-eo t "tfu{A&Q L't . d*$'J{ . r,Jc-, ca-$ Jurisdiction E-Mail , aI .ca 3000-323-006 rovogr RESTRICTIONS : Cannot operate wi th a signal preempti6n Page 4 of 5 devlce. AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL E] E MZ-_W 6. Permit Validation: I certify that:r,-,, j I a' All of the information given in this application is correct to the best of my knowledge and provided in' its full format to the undersigned chief law enforcement officer or nre cn'iei iif tne venicte is t0 be usedfor.firefighting purposes) of bach primary jurisdiction in which the vehicles ire to be used ar - - authorized ernergency vehicle(s)- b' None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor servedany sentenc..es or periods of probation fo.r any fbbnies, nor arrested and convicted of a Oiug oiiiconolviolation or jllegal use or possessio-n- of drugd, nor been required to register as a sex offendir, norhave any of them been adjudicated incompitent or insane. c' Only the vehicle(s) and equipment listed.in this application will be used as oulined in this application,and that only the operators listed under this perniii will drive the vehicle(s). A's the Piiinary holder or executive officer in charge of overseeing thls permit, I understand that if the permit is 'issued, it is my responsibility to ensure: a. No driver listed in th.is permit uses the vehicle for private purposes unless all emergency equipment isremoved or covered. b. No driver other than those listed u.nder this app,roved permit operates the vehicle(s) listed unless allemergency equipment is removed or covered.' 'lf I wish to add a new driver or veni6te to tnis peimit, tmust receive prior approval before they are authorized under this permit. c' The driver must exercise due care and caution and must obey all traffic laws. I understand that the inappropriate or misuse of authorized emergency vehicles may result in criminal or civilliability as well as cancelidtion of this permit as outtined unoeicnlpi"Tzol:bo wAcl " ln.addition, I understand that it is my responsibility to ensure that a copy of this permit and list of aooroveddrivers are present in each vehicle it atliimes anb must oe preient-d% iil e-#;.|';;i if-;"qrJff:"" : l Signature Title Fno,',/* -'?(cHrEF oFFrcER) Name z.,e-*Date (TYPE OR PRINT) 7 ' Certification: TJtis.renewal ap_Plication for Authorized Emergency Vehicle Permits will not be acceptedunless CERTIFIED !V tlt" chiellaw enforcement ofiicer or fir6 chi6f 1ir tne veniciu-ir to be used forfirefighting purposes) of each prinrary jurisdiction in which the vehiclis are to ne used as authorizedemergency vehicles (see part 4 of this application). lf the application is made by the chief of j fr*enforcement agency 9r.fire department, it must nej cenlrfED by the nJao oti6e potitical sub-division. Thecertification must contain the following language: "l hereby ",94iry that I have reviewed this entire application; that I am aware that the appticant intends touse the vehicle(s).and emergency.equipment listeb'as speiifically described in part z tjrtnis appficJtion;thata need continues .to exist.in my jurisdiciion for the tisted vehicles io be used at Srinori="0 e#id;;t ' vehicles and that the applicani has the-appropriate authority as described in part 3 of tn15 appfiiitiJn'tooperate such equiprnent; and I know of no reison why this application shoul& be denied." Please type or print: Signature Name (Please Prini) . Phone +7 Date p4ful riue 4*o erJ 6 .AJi3 )egr-47/L( C*reF "'Jurisdiction E-Maii Ld7. Q enyopFe,u&L..+f .An 3000-323-006 (05/09) E8e JW tel Feoc4c- ry Page 4 of P'ee Ay Eovtfmatr rrls Nar AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H,F-"HMWtr 6. Permit Validation: I certify that: a. All of the information given in this application is correct to the best,of my knowledge and provided in its full formatto the uidersigned chidf law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes) of each primary jurisdiction in which the vehicles are to be used as authorized ernergency veh icle(s). b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane. c. Only the vehicle(s) and equipment listed in this application will be used as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the primarV holder or.executive officer in chqrge of overseeing,this pe.rrnit, I understand that if the permit.is issued, it is my responsibility to ensure: a. No driver listed in this permit uses the vehicle for private purposes unless all emergency equipment is removed or covered. b. No driver other than those listed under this approved permit operates the vehicle(s) listed unless all emergency equipment is removed or covered. lf I wish to add a new driver or vehicle to this perrnit, I must receive prior approval before they are authorized under this permit. c. The driver must exercise due care and caution and must obey all traffic laws. I understand that the inappropriate or misuse of authorized emergency vehicles may result in criminal or civil: : , liabilityaswellascancellatibnoftlrispermitasoutlinedunder,,chapter204-36WAC:,,.' ". :, '.,"t,.'1, lnaddition,,lunderstandthatitismy:responsibility,toensurethatacopy:of,this,permit,and'listof approved,t''r:'i::'i '.i drivers are prelsent in each vehicle- at all tirnes and must be presented to law enforqement,rif requested. ; , , , ' I Signature Title F*-o. i;,Jc -? (cHrEF oFFrcER) Name ,97r"-i/p-* Ro^fi Date (TYPE OR PRINT) Certification: This renewal application for Authorized Embrgency Vehicle Permits will not be accepted unless CERTIFIED by the chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting.purposes) of each primary jurisdiction.in which the vehicles are to be.used as authorized emeis;ndi vehictestse;p;rt A oiinliapptiCationj. tr the application is made by the chief of ? l?w enforcemdnt agency or fire department, it must be CERTIFIED by the head of the political sub-division. Th'e certification must contain the following language: ,r. l. ,r'i:l;'.- i l:i 7 "l hereby certifv use the vehicle(s a need continues to exist vehicles and that the appl that I have reviewed this entire application; that ) and emergency equipment listed as specifical I am aware that the applicant intends to ly described in part 2 of this application; to be used as authorized emergency that equipment; and I know of no leason why this a in my jurisdiction for the I icant has the appropriate isted vehicles authority as described in part ppfication should be 3 of this application to denied."operate such Please type or pri Signature Na (Please Print) Phone Date tg:Z*-re Title Jurisdiction ("y&S*)drz'3 E-Mail C: ./. ?'4 .t /$a RESTRICTIONS: Cannot operate with a signal preemption device. 3000-323-006 (Os/09)Page 4 of 5 "'lr's AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL 6. Permit Validation: ,.,.. ., i ' r ,I certify that: a' $ll-of the information given in this applicationis correct tolhe best,of,my knowledge:and provided in ,, its full forry.at to the undersigned chidf law enforcement officer or iiri - t"iliir the,vehicle is to be usedfor firefighting purposes) of -each primary jurisdiction in which tne venicte! ire to be used asauthorized emergency vehicle(s). b' None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor servedany senten:,?:_"_l q:t^'"d. of probation fo.r any fllonies, nor drrested and convicted of I oiug-oiaiconotviolation or jllegal use or possession- of drugd, nor been required to regiter "s a sex offender, norhave any of them been adjudicated incompltbnt or insane. Yrrvr rvvr' I 'v' c' Only the vehicle(s) and equipment lisled..in this application will be used as ouflined in this application,and that only the operators listed under this perniii will drive neveniifeg.- As the. primary holder or.e.xec.utive officer in charge of overseeing this pernrif .l understand that if the permit isissued, it is my responsibility to ensure: a' No driver listed in th.is permit uses the vehicle for private purposes unless all emergency equipment isremoved or covered. b. No driver other than those listed u.nder this approved permit operates the vehicle(s) listed unless allemergency equipment is removed or covered.' lf t wish to add a new driver or vehiclsto inli.pririt, rmust receive prior approval before they are authorized under this permit. - c. The driver must exercise due care and caution and must obey all traffic laws. I understand that the-in-appropriate or misuse of authorized emergency vehicles,may result in criminal or civilliability as well as cancelidtion of this permit as outtined unoei cnlpte i zoq-gawAC: ln addition, 'l understand that it is my responsibility to ensure that a copy of this permif and list of,approved .',:: ,i drivers are present,in each vehicle it all,tirnes anb-rnust Ue preiented,tb law en?orceinent; it requtjdieO.:- , , , E]EEiL_W Signature Name 1/P-tc (cH rEF EXECUTTVE OFFTCER) Title Date (TYPE OR PRINT) 7 Gertification: This renewal ap-Plication for Authorized Emergency Vehicle permits will not be acceptedunless CERTIFIED !y lne chief law enforcement officer or fir'e cni6t 1ir tnJvenicie'L'io be used forfirefighting purposesfof each prirnary jurisdiction,in which the-,vehioles are,to be used,as authorizedemergency vehicles (se9 part4 of this.application)._lf the applicationis mab" uyln" "nief of a lawenforcement agency or.fire department, itmust uei crnflffED by the n"aO of t6"'pltiticat sub-division. Thecertification must contain the fdllowing language: . I ne.lebV ",",{iry that I have reviewed this entire application; that I am aware that the appticant intends touse the vehicle(s) and emergency.equipment liste'd as speiifically des-ribe- ir p"rt z-of tnis appriiation; tn"ta need continues to exist.in my.jurisdiciion for the listed vehictesio be used as 5utnorizea #;id;;yvehicles and that the applican[ 6as the-appropriate authority as oesiriueO in pirt]oi'tnis appricition'tooperate such equipment; and I know of rio reison why.thislapplication.shoufti Ue OenieO,", ' ' Please type or Signature Name (Please Print) Phone Date ' ,l cll t>Title " 'Jur:isdict ron E-Mail RESTRTcTTONS: cannot operate with a signal preemption d.evi_ce. (L1q<5 t 3000-323-006 (05/09)Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H"HHffiWtr .6, Permit Validation: Icertify that: '' . : '-- i a. All of the information given in this'application'is correct to the best of my'knowledge'and'provided in its full format to the und'ersigned'chief law enforcement officer or fire chief (if t!'re'vehicle is tb bd used for firefighting purposes) of each primary jurisdiction in which the vehicles bre to be uSed as authorized ernergency vehicle(s). b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs,rnor been required to register as'a sex offender, nor have any of them been adjudicated incompetent or insane. l c. Only the vehicle(s) and equipment listed in this application will be used as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the prirnary holder or executive officer in charge of overseeinQ this pe'rmit, I understafld that if the permit is issued, it is my responsibility to ensure: a. No driver listed in this permit uses the vehicle for private purposes unless allemergency equipment is removed or covered. b. No driver other than those listed under this approved permit operates the vehicle(s) listed unless all emergency equipment is removed or covered. lf I wish to add a new driver or vehicle to this permit, I must receive prior approval before they are authorized under this'permit. c. The driver must exercise due care and caution and must obey all traffic,laws. I understand that the inappropriate or misuse of authorized er"rg"n"y vehicles may result ilr criminal o[]civil , '' i, ln addition, I unde-Igtand that it is.rny;r€sponsibility to:ensurethat a iopy of this perdiit and:list of approvr6 i 'ri!'i'i:': ';; drivers are present in each.vehicfe at'all times and must be presented'tb law bnforcement; if iEquested. I " ': " ' I r' ' Signature Title oFFrcER) Name SYe- i/E-*Date (TYPE OR PRTNT) Gertification: This renewal application for Authorized Emergency Vehicle Permits will not be accepted tunless CERTIFIED by the chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting.purposes) of each primary jurlsdiction' in which the vehicies are io be used as duthorized emergency vehicles (see part 4 of this application). lf the application is made by the chief of a law enforcement agency or fire department, it must be CERTIFIED by the head of the political sub-division. The certification must contain the following language: "l hereby certifu that I have reviewed this entire application; that I am aware that the applicant intends to use the vehicle(s) and emergency equipment listed as specifically described in part 2 of this application; that a need continues to exist in my jurisdiction for the listed vehicles to be used as authorized emergency vehicles and that the applicant has the appropriate authority as described in part 3 of this application to operate such equipment; an{ I know of no reason why this'application should be denied." Please type or vtfaz/re Title SrWweF V,t Jurisdiction $lOnOrtf Sli fung ilTV 388 -34t+E-Mail with a signal preempLion device. fr h-t 7 Signatu Name (Please Print) Phone RESTRT ) CT 3000-323-006 (05/09) 1z-S]ONS Cannot operatg Page 4 of 5 f AUTHORIZED EMERGENCY VEHICLE PERMIT E]ER,IMWAPPLICATION RENEWAL 6. Permit Validation: I certify that: a' All -of the informa,tion given in this:application js correct to lhe be-st of my knowledge and provided inits full'format to the undersigned chidf law enforcement oniieror ni" Cn'i"i'iir the vehicle is to b'e usedfor firefighting purposes) of -each primary jurisdiction in which the'vehicles "t" i; b;';;;J;; -" "" authorized emergency veh icle(s).. b' None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor servedanY sentences or P:tlq1g|?robation fo.r any fllonies, nor anested and convicted of I Jiug oiaiconolviolation orillegal use or possessio.n- of drugd, nor been required to r"gLbr "r a sex offendlr, noihave any of them been adjudicated incompltent or insane. c' Only the vehicle(s) and equipment listed..in this application will be used as ouflined in this application,and that only the operators listed under this perniiiwill drive tiltehi;te(s),- As the Plfary holder or executive officer in charge of overseeing thib permit, I understand that if the permit is,issued, it is my responsibility to ensure: a' No driver l:lt-d t]|it permit uses the vehicle for private purposes unless all emergency equipment isremoved or covered. b' No driver other than those listed u.nder this approved permit operates the vehicle(s) listed unless allemergency equipment is removed or covered.' lf I wish to add a new driver or vehiclJto inii piirit, Imust receive prior approval before they are authorized under this permit. - c. The driver must exercise due care and caution and must obey all traffic laws. I understand that the-inappropriate or misu.se of au.thorized emergency vehicles may result in criminal or civilliability as well as cancelidtion of this permit as ouilin;d-rrnd-i "nipt"iz04-36 WAc: ln.addition, l understand that it is my, responsibility to ensure that,a copy of this permit anddrivers are preseRt in each vehicre'it ariimes an'o must:uepr*Lrt"a%'-13vt/';"f##;;i list ;f approvbd if req'u6sted. ' ,. ..ri; r.'::i i: Signature Name (cHrEF oFFrcER) /ea Title Ft-,, .,y'tt -'? Date Date'\0--1,\0 Title CFtt€F sF For ir € ' Juiisdiition (TYPE OR PRTNT) 7 Gertification: This renewalap-plication forAuthorized EmergencyVehicle permits willnot be acceptedunless cERTIFIED by tle chidf law enforcement officer or fir6 chi6f 1ir tnJvenici"-ir-io be used forfirefighting purposes; of each priqary;uiiidiction in wnicn tne vehi.tu, are to be us"o i-"i,in'Jrii.oemergency vehicles (see part 4 of this.application). lf the applicaiion is mloe t th; .hti;i;ifi-enforcement agency or.fire department, itmust bd cERTlFiro ov ne neiot tde'pltiticat sub-division. Thecertification must contain the following language: .'f -ne.lenv ",etgry that I have reviewed this entire application; that I am aware that the appticant intends touse the vehicle(s) and emergency_equipment listed as speiiRcilrv oesirioeo in pa-rt1-or tnis appriiaiion; tn"ta need continues to exist.in my.ldrisdiciion for the listed vehiclei io ne used as iuthorized il;id;;t ' ' - vehicles and that the applicani has the_appropriate qutlglty li uescrineo i" p;; 3 "i ih'rs aptf;td;iooperate such equipment; and I know of rid reison why this application snouiJ Oe O"ni"O." Please type or Signature Name (Please Print) Phone M" Qsg ) Rgi -3oo I E-Mail Buee €Ailgjalf,tpA . Gt U RESTRIcrrONS: cannoL operate with a signal preempLi_on device. 3000-323-006 (05/09)Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H,RHffiWtr 6. Permit Validation I certify that:-. i. : , jJi l: -. ,:- !;r.' I il a. All of the informalion given in this application is correct to the best of ,my;knowledge,and provided in its full format to the undersigned chief law enforoement sfficer or fire chief (itthe vehicle is,to'be used for firefighting purposes) of each primary jurisdiction in which the vehicles are to be used as authorized emergency vehicle(s). b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane. c. Only the vehicle(s) and equipment listed in this application will be used as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the primary holder or e.x.ecutive officer in chqrge of overseeing this permit, I understand that if the permit is issued, it is my responsibility to ensure: a. No driver listed in this permit uses the vehicle for private purposes unless all emergency equipment is removed or covered. b. No driver other than those listed under this approved permit operates the vehicle(s) listed unless all emergency equipment is removed or covered. lf I wish to add a new driver or vehicle to this perrnit, I must receive prior approval before they are authorized under this permit. c. The driver must exercise due care and caution and must obey. all traffic laws. I understand that the ipqppropriate or misuse of authorized emergency vehicles may4 result in cr:iminal or civil liability ai well as cancelidtion of this permit.ag outlined unde4 ch6pteiZ04-36 WAC'.'. . ., ,. .i- . ln addition, J pnCefstand, that it i9 r4y responsibility drivers are prese'pt.i4 epch Vehicle at alltime,sqr,rd to,ensurg, that a copy of this, peqmit and lisl of apppved must be presented to,law enf'orcement, :if.,reg uested.. Title , Fe- e- <; ,y'e o* , t:. ..!j.-:'-.:1.' ri. .:... 7 Signature (cHrEF oFFrcER) Name SYeyea Eu-nful Date (TYPE OR PR|NT) Certification: This renewal application forAuthorized Emergency Vehicle Permits will not be accepted unless CERTIFIED by the chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes) of each primary jurisdiction ,in wlrich the vehicles are to be used as authorized emergency vehicles (see part 4 of this applibation). lf the application ib made by the chief of a law enforcement agency or fire department, it must be CERTIFIED by the head of the political sub-division. The certification must contain the following language: "l hereby certifv that I have reviewed this entire application; that I am aware that the applicant intends to use the vehicle(s) and emergency equipment listed as specifically described in part 2 of this application; that a need continues to exist in my jurisdiction for the listed vehicles to be used as authorized emergency vehicles and that the appl operate such equipment; Please type or print: Sign Na (Please Print) Phone icant has the autho and l:know of no reason why pplication to py'/o riu.'--7 7 'h I r' -. -\ H/E S- //LO Jurisdiction i..r'j Vtr ) c/:?_6zt &el/rz CLt,l- e.RESTRTCT]O 3000-323-006 (0s/09) NS: CannoL operate E-Mail fr,'t/ctwith a signal pr eemption devic Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL mmm-.FIsFlicifiSffiEiEdWT 6. Permit Validation: I certify that a. ' All of the information given in this application is correct to the bbst of my knowledge and provided in'its'full format to the undersigned chief law enforcemerjt officer or fire chief (if the Vlhicte is to be usedfor firefighting purposes) of each primary jurisdiction in which the vehicles ire to be used aiauthorized emergency veh icle(s). b- None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor servedany sentenc..gs ol periods of probation !o1 any felonies, nor drrested and convicted of a diug or alcoholviolation orillegal use or possession of drugi, nor been required to register as a sex offendir, norhave any of them been adjudicated incompetent or insane.' c: Only the vehicle(s) and.equipment listed in this application will be used as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the. PlTary hclder or executive officer in'charge of overseeing this perrnit, I understand that if the perrnit isissued, it is my responsibility to ensure: a. No driver listed in th.is permit uses the vehicle for private purposes unless all emergency equipment isremoved or covered. b- No driver other than those listed under this approved permit operates the vehicle(s) listed unless allemergency equipment is removed or covered. lf I wish to add.a new driver or vehiite to this perrnit, Imust receive prior approval before they are authorized under this permit. c. The driver must exercise due care and caution and must obey all traffic laws. I understand that the ina,ppropriate or misuse of authorized emergency vehicles may result in criminal or civilliability as well as cancellation of this permit as outlined under chlptef zoa-ga WAc: , ln.addition, l;understand tfrgt i! 1s.my.regpgnsibility. to ens.ure,that a pgpy of this peimit and list of approveddrivers are present'in each,vehiele it all'times and,must be presenieo tb taw en'tbrcement, if requdsted. Signature Name (cHrEF oFFrcER) Title Ft-o ,;,J. ^? .9Yz rt B*-n:fr.t Date 7. Certification: TJtis.renewal ap-plication for Authorized Emergency Vehicle Permits will not be acceptedunless CERTIFIED !V lne chief law enforcement officer or tir6 chibf (if the vehicle is to be used for ' firefighting purposes) of each primary jurisdiction in which the vehiclis are to be used as authorizedemergency vehicles (see p5rt 4 of this applicbtion). lf the application is made by the chibf of a lawenforcement agency 9r.fir9 department, ilmust Ud Cf nlfiED by the head of the political sub-division. Thecertification must contain the following language: "l hereby c,94iry that I have reviewed this entire application; that I am aware that the applicant intends touse the vehicle(s).and emergency equipment listeb as specifically described in part Z 6f tnis apptication; thata need continues.to exist.in my.jurisdiciion for the listed vehicles io be used as iuthorized emeigencyvehicles and that the applicant has the appropriate authority as described in part 3 of this appticltioniooperate such equipment; and I know of rio reison why this'appticainn JnoutJ ne OenieO." Please type or prinL : , t' - ' ' Signature,Date 1 Title Name (Please Print)' Jurisdi0tion Phone, (e (wPE ORPRTNT) E-Mail RESTRrcrroNS: cannot. operaLe with a signal preemption device. ) 3000-323-006 (Os/09)Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H,E*.HMWtr k I 6. Permit Validation: I certify that: a. All of the, informatisn given in,this application is correct to:the:bestlof my knowledge and,provided-in its full formatto the undersigned chief law enforcement'officer or fire chief (if the vehicle i3 tb be used for firefighting purposes) of each primary jurisdiction in which the vehicles are to be,used as authdrized emergency vehicle(s). 'b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent.or insane. ' : : c. Only the vehicle(s) and equipment listed in this application will be used as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the primary holder or,executive officer,in chqrge of overseeing,this pennit,,l utnderstand th:at,if the permit is , , ,' issued,'it is my responsibility to'ensure: a. No driver listed in this permit uses the vehicle for private purposes unless all emergency equipment is removed or covered. b. No driver other than those listed under this approved permit operates the vehicle(s) listed unless all emergency equipment is removed or covered. lf I wish to add a new driver or vehicle to this permit, I must receive prior approval before they are authorized under this permit. c. The driver must exercise due care and caution and must obey all traffic laws. I understand that the inqppropriate or misuse,of authorized emergency vehicles may result in criminal sr civil ' . ' ' ln addition, l understand that it is my, responsibility to ensure that a copy of.this, permit ?nd list of approved ; ' '; ', . : ' drivers are pregent in each vehicle at ail times and must be,presented to law enforqeme.nt, if requested: - , : . ' Signature Title (cHrEF oFFrcER) Name .9Yp, i/P-',Date (TYPE OR PRINT) Certification: This renewal application for Authorized Emergency Vehicle Permits will not be accepted unless CERTIFIED by the chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting .purposes) of epch primarv jurisdiction,in which the vehicles afe lo be used as authorized , emeigenCy'vehicles (see part 4 of this application). lf the application is madp by,the chief of a law enforiement agency or fire department, it must be CERTIFIED by the head of the political sub-division, The certification must contain the following language: "l hereby certifv that I have reviewed this entire application; that I am aware that the applicant intends to . use the Venicletsl and emergency equipment listed as specifically described in part 2 of this application; that a need continues to exist in my jurisdiction for the listed vehicles to be used as authorized emergency vehicles and that the applicant has the appropriate authority as described in pafl 3 of this application to operate such equipntent; and I know of no feason why this applicatio4 should be denied." : Please type or Signature Name. (Please Print)Jurisd E-Mail Jfuaq^t 6a.E'4t^t6etzae: liz; tk' dS' 7 E6Phone ' (Lq. )7ga'RESTRrcrroNS: cannot operate wj_t.h a signal preemption device. 3000-323-006 (05/09)Page 4 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H"H'HffiWtr 6. Permit Validation: I certify that: r a. All'of the'informatibn giVen'inthis application'is correct'to the bestof my knowledge and,provided in I its full forrnat to the undersigned chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes) of -each primary jurisdiction in which the vehicles are to be used as authorized emergency vehicle(s). b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a_.drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane' c. Only the vehicle(s) and equipment listed in this application will be used as outlined in this application,. and that only the operators listed under this permit will drive the vehicle(s). As the primary holder or execritive officer id charge of overseeing this permit, I understand that if the permit is issued, it is my responsibility to ensure: a. No driver listed in this permit uses the vehicle for private purposes unless all emergency equipment is removed or covered. b. No driver other than those listed under this approved permit operates the vehicle(s) listed unless all emergency equipment is removed or covered.' lf I wish to add a new driver or vehicle to this permit, I must ieceive pri6r approval before they are authorized under this permit. c. The driver must exercise due care and caution and must obey alltraffic laws. I understand that the inappropriate or misuse of authorized emergency vehicles mqY result in criminal or civil liability as welt as'canceliation of this permit as outlined under chapter 204-36 WAC. :and that it is my responsibility to ensure that b,,copy,of this permit and list of apploved ,, ; 'ln addition, luhdersl drivers are present'in each vehicle it all times and rnust.be presented to'laW enforceinent, if ,requested; ' , : ,. . , Signature f tile Fl- e-< i,rle af (cHrEF oFFrcER) Name lYr"- i/ tz-.* E *-*fi Date (wPE OR PR|NT) 7 Certification: This renewal application for Authorized Emergency Vehicle Permits will not be accepted unless CERTIFIED by the cni6f law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes)'of each primaiy jurisdiction in which the vehicles are to be used as authorized emeigendy'vehicles ise6'pdrt 4 of this application). lf the apllication is made b.y the chief of a law enforiemdnt agency br firb department, lt must bd CERTIFiED by the head of the political sub-division. The certification must contain the following language: "l hereby certifv that I have reviewed this entire application; that I am aware that the ap-plicant intends to.. use the ve-niclefsl and emergency equipment listeb'as specifically described in part 2 of this application; that a need continu6s to exist in my jdrisciiction for the listed vehicles to be used as authorized emergency vehicles and that the applicanf has the appropriate authority as described in part 3. of .this_application to operate such equipmeni; and I know of no reason why this appliCation should be denied.' Please type or print: Signature Name .'(Please Print) ''., ',Date,10-l 2-10 Jitls Chief of, Po].ice-,-r,'': ,.'.t' Phone ( 360') 82s,-350s i' 'Ju'risdiction city of Enumclaw'Po1f-ce' . , E-Mail jlmz@police.cid'enumclaw.wa.us ' Jiitr ZoLI' 3000-323-006 (05/09)Page 4 of 5 AUTHORIZED EM ERGENCY VEHICLE PERMIT APPLICATION RENEWAL Etsm4-, WTSHNGTOH STAI€ PITROLWtr 6. Permit Validation: I certify that: a. All,of thb;linformation given in this application is correct to the,best of'my knowledge and p't,ovided in its,fult form;i'ir'inJ'riol*ign;d cnidf raw enforcement officer or fire chief (if the vehicle is to be used for firefighiiib'p;;t"teai otiacn piir"rylrliidiction in which the vehicles ire to be used as authorized emergency vehicle(s). b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of ptoUaiirin for ;;y ielonies, nor inested and convicted of a drug or alcohol violation or illegal use or potiesrion of drugd, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane' c. only the vehicle(s) and equipment listed in this application will be used as outlined in this application, and that onty tnd operatori listed under this permit will drive the vehicle(s)' As ihe primary holder or"executive officer,in cha.rge of overseeing this permit, I understanfl. that if the permit is issued, it is my responsibility to ensure: a. No driver listed in this permit uses the vehicle for private purposes unless all emergency equipment is removed or covered. b. No driver other than those listed under this approved permit operates th.e vehicle(s) listed. unless all "r"rg"n"y equipment is remoueo'or iouereo.' tf I wish to add'a new driver or vehicle to this permit, I must recei'vJ piiirr approval before they are authorized under this permit. c. The driver must exercise due care and caution and must obey all traffic laws. I understand that the inappropriate or misuse of authorized emergency-y9.ht^qle.:,.r.nqy result !n crim! n,a.f ql civil , , ,. : : ii"oiritv Li well at c"*"tiiiion of this permit'as outlined'under chapter'294'36 W49'., i ' . .: ''1 "r:1 ' ', ln addition,'I' understand that;it drivers are presiint in each;veh Signature ts of , . .; - l . : t,' (CHIEF EX Title DateNameP, i/P,.',/t E*^fe / 7 Certification: This renewal application for Authorized.Eme-rgenc.y lenicle Permits will not be accepted unless CFRTIF1FD nt, 6e cni6f taw enforcement officei or firE chi-ef (if the vehicle is to be used for firefishtins prrpo.u.1'oi;;;;ri;;i-;;;[J;"ti";'.t t-l':n the.vqhiclds are,to be used as authorized ;;;;;r;yGfiiii"r i#" p"rt? "iinit'"gnliCJtionl. [!tr 3.pflTtion is made ?,v-in." chief of a law enforcement agency or fire department, it mr"i uJ'cenfrrieo by the'head of ihd'folitical sub-division' The certification must contain the following language: (TYPE OR PRINI) ,l (, Jur:isdiction Please type or print: Sigpatqr_e-' Name (Please Prin!) Phone Title cv" [a,fl e C t', t{'l'ci' dA' that 3000-323-006 (05/09) /rY-E;Mail Page 4 of 5 • a ' _ -' ' 1 � -fir'■ i � Y ••I . r � I a. 1 1 I• I I I :• • I I I I — r. ►�� I 1 , _ I Y. h ul I 1 1 •I I L• � I h • I AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL H.F""HMWtr WASH INGTON STATE PATROL EQUIPMENT & STANDARDS REVIEW UNIT GEN ERAL ADMINISTRATION BLDG PO BOX 42600 OLYMPIA WA 98504-2600 Person, Company, Department, or Agency (if a person, must list agency/department representing) DATE APPROVED: VALID UNTIL: CAPTAIN (For Department Use OnlY) This application must be submitted by the Chief Executive of the firm or corporation making application' Ptease type or print in ink. e Address Ycl t>I L.,/ F/ "/,.*or #t e> City State L,/t+ ZiP qR//6 Phone (,Zoa ) ?<Z"Z pFa E-mail -ffla^rfe./ A^ao ? @rva-4ua - c-o;o1 Vehicle lnformation: List all vehicles being used as authorized emergency vehicles. For each vehicle, provide both the vehicle and emergency uquipment information as outlined below. Any new vehicles-or vehicles with equipment installed itnerinun what is authorized on the current permit for that vehicle-must receive prior approval before being utilized under this permit' 1 OTHER EQUIPMENT: .: veHicle INFORMATION' YEAR 7oi o 9,+qAtY LICENSE NO. MAKE MODEL L VIN OWNERRE EMERGENCY EQUiP MENT INF MAKE ORMATION MODELINSTALLED LAMP COLOR(S) LAMP MAKE/MODEL h SIREN ) VEHICLE INFORMATION r' : i. YEAR Lbtl LEF' LICENSE NOfrtt MAKE MODEL VIN i IS D ER /;,- //4i<,De,// PMENT IN MAKE TION MODEL FORMAEMEQU INSTALLED SIREN l*,e LAMP COLOR(S) MAKE/MODEL OTHER EQUIPMENT: 300G.323-006 (0s/09)Page 1 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL RF"HMWtr VEHICI.E INFORMATION 3. YEAR LICENSE NO. p MODEL VIN itl"Dr f///'t t-rqv 6zBtt? R ED OW EMERGENcY EQUIPMENT INFoRMATIoN INSfALLED. ,': nnxe naOoel l2[ srnrru l. s,lo/"tt ffi. r-nri/lr coloR(s) tJ/,e/et flrdtE nszr,fP MAKE/MODEL Rc.'{ OTHER EQUIPMENT: OTHER EQUIPMENT: OTHER EQUIPMENT: OTHER EQUIPMENT: Note: This page may be copied if additional vehicles need to be added to the permit. Any additionalsheets attached must provide the vehicle and equipment information in the same format as above. YEAR LICENSE NO VIN ( r.,.i 4. r IREN LAMP COLOR(S) LAMP ODEL t-t, /'. e, /e.t't$qryeNE r-nr,an coloR(s) ui u/rt" I Ae'l LAMP MAKE/MODEL YEAR LICENSE NO EL L &o t trtllt / o DB to6 Ar, VIN / o REGI Lr_ttvLL.tIt!. vt\ltlta I l\rI:l \li. : tr': "r:i: LICENSE NO. N t2 L YEAR MAKE a MODEL 6. "/J M* ISTR El stnrN t.r'/ e'-/n-o lEr-nrvrr coloR(s) LAMP MAKE/MODEL ilAe ./. n 3000-323-006 (0s/09)Page 2 of 5 AUTHOR IZED EMERG ENCY VEHICLE PERMIT APPLICATION RENEWAL Hr*ts"HmWtr 6. Permit Validation: I certify that: a. All of the information given in this application is correct to the best of my knowledgg 9ld provided in its full format to the uidersigned cnidf taw enforcement officer or fire clrief (if the vehicle is to be used for fireflghting purposes) of Lach primary jurisdiction in which the vehicles are to be used as authorized ernergency vehicle(s). b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentenie" oipbiloOs of probation for any ielonies, nor arrested and convicted of a drug or alcohol violation or illegal use or posiession of drugs, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane. c. Only the vehicle(s) and equipment listed in this applic.ation will be used as outlined in this application, and-that only the 6perator3 listed under this permit will drive the vehicle(s). As the primary holder or executive officer in charge of overseeing this permit, I understand that if the permit is issued, it is my responsibility to ensure: a. No driver listed in this permit uses the vehicle for private purposes unless all emergency equipment is removed or covered. b. No driver other than those listed under this approved permit operates the vehicle(s) listed. unless all emergency equipment is removed or covereiJ.' tf I wish to add a new driver or vehicle to this permit, I mustieceive pribr approval before they are authorized under this permit. c. The driver must exercise due care and caution and must obey all traffic jaws' I understand that the inappropriate or misuse of authorized emergency_F.hlclgq.ryray result in criminal or civil liabitity as well as'cancelidtion of this permit as outlined under chapter 204-36 WAC. ln addition, I understand that it is my,responsibility to ensure that a copy of this permit and li-st of approved oiiv"ii jre present in each vehicle it alltimes an-d must be presented tb law enforcement, if requested. Signature Title (cHrEF oFFrcER) Name i/ e,-tr e Date (TYPE OR PRINT) 7 Certification: This renewal application for Authorized Emergency le-hicle Permits will not be accepted ,nf "ss CEnTIFIED by the cni6f law enforcement officer or fire chief.(if the vehicle is to be used for nrenghting puiposes;'oi eacfi primary jurisdiction in which the vehicl6s are to be used as authorized fi#d.;yGhiti"iiseepart4of thisapplication)._lf the.application igma.de-b.ythechief of alaw enforiement agency birirE o"partment, it must bd cERTtFieo uy the head of the political sub-division. The certification must contain the following language: "t hereby certifv that I have reviewed this entire ap.plication;. that l am aware that the .p.p^1,1",_"T_,ll:19:^t9.-^, use the venffis1 and emergency equipment listed as specifically described in part 2 of this appllcatlon; tnal a need continues to exist in iry jriris<iiciion for the listed vehicles to be used as authorized emergency vehicles and that the Jpplicanf nas tne appropriate authority as.described in part 3. of .this application to operJte sucn equipmeni; and I know of rio rebson why this'application should be denied." Please type or Signature Name (Please Print) Phone Date Jurisdi E-Mail lolt t> Title (L1q<5@s 3000-323-006 (05/09) ction i/\ Page 4 of 5 u["(u\ AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL EtsM,_w s!!!cl9!_!urEM!9! WDtr 2 Purpose of Application: Describe the specific purpose for which the vehicle(s) shall be used as authorized emergency vehicle(s) and what necessitates the vehicles' registration as emergency vehicles Explain the nature and scope of the duties, responsibility, and intended use of emergency equipment. i,/e. eJ c ot* f nnerd/ ,ferui.-S 3. Authority:Explain authority outlined under statute (Revised Code of Washington) that allows the vehicles' operators to use emergency equipment for the purpose outlined under part 2 of this application. ftc''tt16-6/. ovf 6) f"rt4".fu'1fage. af f*^-v'/ €ec6a-t'1; oq*4 wa'r/ei"y r,le *icej n t girorn:ele.l i u t| C u/ "/6.7 V. if"y' ui6,7 Z tfrl .z! auT4c*i'zeJ q,,".1 o*f/in-,/ t'h 71,'g f e.reu,-t 4 Geographic Area: Check which types of roads you will be operating on and state the specific geographic area(s) in which the vehicles shall be used as authorized emergency vehicles (city, county, etc.). (Certification from each primary jurisdiction is required under part 7 of this application.) n City Streets (list allcities) tr County Roads (list all counties) n State Routes/lnterstates A,rjrdgT./p.f s'r-a7.,r2.?i/qql.<-b"/,r f.tl/ort6fi\t- qst>tt€ 5. Operators: Please list all drivers that you intend to have operating the vehicle(s) listed in this application and indicate whether or not the operator/driver is new since your last application. (Use additional sheet if necessary) OPERATOR/DRIVER NEW OPERATOR/DRIVER NEW OPERATOR/DRIVER NEW tr tr tr tr tr tr il ! tr ! D ! ! tr tr D ! u n ! ! 3000-323-006 (05/09)Page 3 of 5 October 3,2010 Dear Chief of Police: Washington State Motorcade, Inc. is cunently in the process of renewing our motor escort permit aq issued by the Washington State Pahol. Each year our renewal application is required to be certified by the chief law enforcement officer of each jurisdiction in which we operate. ln past years we visited each jurisdiction in person to have the permit application signed, however, we- frequently experienced difficulty fitting into each Chief s schedule. Therefore, we are attempting to deliver them by mail in order to minimize the impact on your calendar. This will allow you to sign the application at your convenience rather than ours. The permit application that is enclosed includes all ofthe applicable information. Please sign the permit and retum it (you only need retum the sheet with your signature) so we can forward it to the State Patuol. If possible, please mail this as soon as your schedule permits so we can have them submitted to WSP by the end of October. To assist you in completing this application, I would like to provide you with some background information about our organization. Our organization employs only the most experienced and most highly trained riders. Our training program is the most comprehensive in the industy and requires training in safe escorting procedures, a supervised apprenticeship program, and an advanced motorcycle operator's course instructed by CJTC certified insfructors. t learly all of our operators are either professional pdlice officers or professional firefighters who are certified in emergency vehicle operation. Washington State Motorcade maintains two million dollars in professional liability insurance. If you have any questions regarding this application or would like to see us in person, please feel free to call me directly at206-932-3870. Respectfully, fuE".wL Steven Bartel President Washington State Motorcade, Inc. 4409 SW Admiral #102 Seattle, WA 98116 206-361-2221 CHRISTINE O. GREGOIRE Covernor April 28,2010 Mr. Steven Bartel Washington State Motorcade 4409 SW Admiral#102 Seattle WA 98116 q"Ep.'$A'Y,B.D l,tAy 0 a Zfin STATE OF WASHINCTON WASH I NCTON STATE PATROL General Administration Building o PO Box 42600 . Olyrnpia, WA 98504-2600 r (360) 596-4000 r www.wsp.wa.gov IGf\fl'Pq"NF DEPART,I'ENI IOHN R. BATiSTE Chief Dear Mr. Bartel: It has come to our attention that the Authorized Emergency Vehicle Permit (AEVP) being carried in the vehicles authorized under your permit may not be the same AEVP authorized by this office. The original renewal application you sentwas not authorized by this office. Amendments were made to the application, removing RCW 46.61.035 from the authority listed under your permit as this RCW only pertains to authorized emergency vehicles"wlten responding to an emergency call or when in pursuit of an actual or suspected violator of the law or whten responding to but not returningfrom a/ire alarm." Since funeral escorts do not meet any of these, you do not have the authority to Oxercise the privileges set forth under RCw 46.6r.03s. Only the AEVP issued by this office is authorized. If an altemate permit is being carried in the vehicles, it may be cause for us to revoke your permit as outlined under Chapter 204-36 WAC. Please ensure a copy of the permit as issued by this office must is carried in each vehicle or motorcycle at all times. Another copy of the authorized permit is enclosed for your convenience. If you have any questions, please call Ms. Melissa Van Gorkom at (360) 596-4017. Sincerely, C G Relations GB: mvg Enclosure cc: , ,Captain Steve Burns, District 2 - Bellevue Chief Jim Collyer, Puyallup Police Department, ', 'r, Chief Al Compaan, Edmonds Police Department , & rEp Page 2 Mr. Bartei April2s;2010 Captain JeffDeVere, District I - Tacoma l Captain Ken Ginnard, District 7 - Marysville .-.. ..,- "Chief Andy Hwang, Federal Way police Department ., . , ,... ,Clie.,ffteveruIensen, Lynwood police Department '.:"' Sheriff John Lovick, Snohomish County Sheiiffs Office Chief Linda f;illor ,Bellevue Folic.q Departmeni' rr , '' ' 1 '1 i .r :,, ri: -'Chief'iim Scfrarf, bvereu police Department Chief Steven Shachan, Kent Police Department Ms. Melissa van Gorkom, Equipment and standards Review unit, Chief Greg Wilson, Mountlake Terrace police Department Chief Jim Zoll, Enumclaw Police Department rY,_. rv I Lt tt\rl.L r l_f\tril I APPLICATIONI ./, RENEWAL WL ': , ,, . 'l : .-' i WASHINGTOru SiNrE PATRCJL : EQUIPMENT & STANDARDS REVIEW GENERAL ADM IN ISTRATION BLDG PO BOX 42600 oLYMP|A wA 98504 -2600 UNIT #1e:i DATEAPPROVED:December 14, 2009 VALID U 111111. Novenber 8 , ZOLO CAPTAIN ..' (For Use Only) Please type or print in ink.,. Address Phone Slate Ut,4 Zip ?-i ' E-mail 1 ...'vehicle lnformatioti: List all vehicles being used as authorized emergency vehicles. For ebch vehicte,provide both the vehicle and emerget"y "qriqment i'niorm"ilon-"s ouflined below. Any new vehicles-or , vehicles with equipment installed itr,"rirtan wnat is ruinoil"i'on the current permit f6r: that vehicl+-mustreceive prior approvarbefore being utirizeo una"iir,i"E;ii- - r-AMP COLOR(S) I.AMP OTHER EQUIPMENT: : .1 OTI,IER EQUIPMENT TA EIVIERG ENCY ENTEQUIPM TIONINFORMA INS LLED MAKE MODEL B"+E[ED ALSfe., .i:.,.,: . .. . 1.:rid,r-;:,;,, AUTHORIZED EMERGENCY VEHICLE PERMIT t N RENEWAL .OTHER EOUIPMENT: 3 O..' vehic LE INFORI'}ATiON YEAR LICENSE NO. OWNERREG 1l*t AUTHORIZED EMERGENCY VEHICLE PERMIT APPLTCATION RENEWAL HJr*.ffiWT n2-Purpose of Application: Describe the specific purpose for which the vehicle(s) shall be used as authorized emergency vehicle(s) and what necessitates the vehlcles' regisiration as emergency vehicles. Explain the nature and scope of the duties, responsibility, and intended use of emergencylquipment. 3- Authority:. operators to n authority outlined under statute (Revised of Washington) that allows the use emergency equipment for the purpose ouilined under part 2 of this application. ; 4.Geographic Area: Chgck which types of roads you will be operating on and state the specific geographic area(s) in which the vehicles shall be used as authorized emergency vehicles 1city, coui!f61: - (Certification from each primary jurisdiction is required under pirt z bt this applicai'on.) I Clty Streets (list allcities). lt tr County list allcounties) . /f;ttcn4 -*A^tU:-fu-"fu "ttV d llrt <.gcort!ilcf?/ ,..t'4 aZ in -t)frr o!- af f".4?2./,u;4utc-taity o(a " tae,J 4t /.o Rcru v|jf. 12o onrv 4[rt+,oyirrhcr,t hq^,c *fiffiSTt rn {tre,. \u,rlFq6 qrb\tv€ct tr -f$ TTEcf 6l; f22_.fDr ?- 7r/{az, ctg/ ?/? tsts(slstz. 5. Operators: Please list all drivers that you intend to have operating the vehicle (s) listed in this application and indicate whether or not the operator/driver is new since your last application. ;P *"qo (use if necessary) t!. .Fllh't!r'Q.ru;,Srs t* a+i ,.,- .,".q_ , ar{.."p . 6"J ""- - -*1L,. ,, -;t'.1 :rr *t * **hY NEW NEWOPERATOR/DRIVER'OPERATOR/DRIVER NEW tr tr tr tr tr tr u yl Y r)5 u n D u u D u D D tr E D tr D . '. ',.1" ',:f'*,i*.i l'-. 3000-323-006 (05/09) t' q* ''+ :. "& ,,;tl h, Page 3 of 5 AUTHORIZED EMERGENCY VEH ICLE PERMIT APPLICATION RENEWAL a. .' Al! of the:information given in this application is correit to the best of my knowledge ?ld provlded in ' ' -',,, ,' iti,rrrr iomri to ih; uidersigned cnidf law enforc.eme.nt officqf or fire chief (if the vehicle is to be'used iJ; nietigntlng purposes) of -each primary jurisdiction in which the vehicles are to be used as authorized emergency vehicle(s). b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any senten;;;;; #taJof probatidn for any ielonies, nor irrested and convicted of a drug or alcohol vioiation or illegal use or possession of drugi, nor been required to register as a sex offender, nor have any of thEm been abludicated incompetent or insane. c. Only the vehicle(s) and equipment listed in this ap.plic.ation will be used as outlined in this application, andthat only the operatori listed under this permit will drive the vehicle(s). As the primary holder or executive officer in charge of overseeing this permit, t understand that if the permit is issued,'it is my responsibility to ensure: a. No driver listed in this'permit uses the vehlcle for private purposes unless all emergency equipment is rernoved or covered. , -i ,. ; ,,' ; , , ., r i b. ' No driver other ihbn inose tisieit underinjq appro,ved permit operates the vehicle(s) listed unless all ;5if;;"t;fuii.;ii;hilJi"nioueo br cov-bied." tti wisn to add a new driver or vehicle to this permit, I ' mustieceive iribr approval before,they are authorized under this permit' c. The driver must exercise due care and caution and must obey all traffic laws. t understand that the inappropriate or misuse of authorized emergency^veh'^cl",q.Tiy result in criminalor civil liability as wellas cancelidtion of this permit as outlined under chapter 204-36 WAC. ln addition, I understand that it is my responsibility to ensure that a copy of this permit and list of approved oiiu"rs'"t" pr"r"ntln "u"n ueniip 6t alliimes an'd must Qe preseqted to law enforcement, if reque.sted' 6. Permit Validation: I certify that: Signature Name Please $pe or print: Signature Name ,, (Please Prinl) Phone 5rvPE OR PRINT) . Title I-lato 4 7 Certification: This renewal application for Authorized Emergency letricle Permits will.not be accepted unless CERTIFIED Ov tne ini*if U", enforcement officer or fire chi-ef (if the vehicle is to be usgd for . iirenghting purposes;'oi Jaln prirary jurisdiction in which the vehicl6s are to be used as authorized ;#;g;;i u"iiicies i#; t;rt h-' oi tnis apprication).- lf the. application is made by the chief of a law enforcement agency'Jr-nr! o"p"rtment, it muii u,j cenlriED by the head of the political sub-division. The certification must cdntain the following language:] ': ,,t hereby certifv that I have reviewed this entire application;.that I am aware that the "!,p^1.,91t-'lplg:j9-.^usJtfe'vlnrc-r"pl and "mergency equipment list# as specifically described in part 2 of this application; that a need continues to exist in iry jririsdiciion for the listed vehicles to be used as authorized emergency vehictes and that tne appfilani fi"j tne appropriate authority as.described in pgrt 3. of.this-application to operjte such equipm"f,{ ""0 i know of rid rebson why this-application should be denied,", Date Jurisdiction (Vtri CZa d(ot E-Mail : \^,t< aF-I B fre4e. yl"re 3O0G323-O06 (05/09)e&Vq u\rnrts. tft Page 4 of 5 No*e,:e,[.t^*4no4 r13e{ \JrFet-\6e dpui e€i*r-,i n $.re) j ir jj iii+ : ii ri certification: This renewar i6bridaiion,fdrAuin orized EmergenCy Viinicle permits williiof be acCeBted' unless CERTIFIED by the chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes) of each primary jurisdiction in which the vehicles are to be used as authorized emeigency'vehicles jsee part 4 of this application). tf the application is made by the chief of a law , enforcement agency or fire department, it must be CERTIFIED by the head of the political sub-division. The certification must contain the following language:. that Please type or print:ISignature4ateTitle Name ( (Please Print) -\] '\Yr\ (frly4*U Jurisdiction E-Mail p /4.t Phone (fi? ) APV4\S NOlie:ryrt u,[hnort-ze \ r,ua€ of gfi'rgr (vhA P."r+ n+ 0\,h c,t sf rc.-f\. \kl,e Page 4 of 5 \ 3000.323-006 (0s/09)Outs 1\\{rn{rt, Please type or Signature Name (Please Print) Phone t: '3 I a It Date 1.0-1e-09 Tifle Ghief of Police Jurisdiction .''- 'E-Mail ',,.l Police ( roo ) ezs-rsos Page 4 of 5 3000-323-006 (05/09) Please iype or Lr Signatu Name (Pleas€ Print) Phone Nole .oN ,D Jurisdiction E-Mail('lt curt-r) (Yr "q).oIO,n?e rn or\-r{ t nn C)i , e t 300s323-O06 (05/09) Please type Name (Please. Print) Phone ('t{-l 6{n hbYEI CLuVnonzeS Date loozof Title Df,Prl:rz Colr,sF Jurisdiction' '..r i I',ta Page 4 of 5 T v $-1 ti rrt"tg 'E-Mail 'r{ir ltzaA fl,r-o Date Title Jurisd E-Mail I //c:t <l/e,WeCutq,&)"{Phone Nboho 3000-323-006 (05/09) t%u^ c L{-\,{ \inrvrt-S. 'cr.lralai *{rr<- Page 4 of 5 l,rease rype or pnnr: Signature Name (Please Frint) Phone No{e : r53 )ess- LztL Date Jurisdiction rE-Mail art :e3 ( \J€€ ct e,.rrrer aelrkLoh cleutoeutG nts o.Jnot ai ren -tt+Fg uere 5 3000-323-006 (05/09) - LryEldlrt -urell Eq Please type or print: Signature Name (Please Print) Phone Ullol.\,1 e\\I-n rJJ\n Page 4 of 5 () '/t7t1^ lJ.t t Title Q r,:rr17- h/4. 4J Date Jurisdi E-Mail o 300G323-O06 (05/09) Please type or Signature Name (Please Print) Phone Page 4 of 5 !(' Date ,Jurisdiction E-Mail Title NJote,. oYl\O.lttflolft?ef gr otr (L>'l ) gSle €€ Qeder:tpnan oe 16 )4enl ct i rni\g . Y, @0t &,rUSq olr" Lr&3 Page 4 of 5 sig Name . (Please Print) Phone ( frlofgS."t Jurisdiction E-Mail' :3ls CtU*41@\nz€s {-f}e ue€ QF lntrs cl./not s[ re./n I dfre 0".tit". i fiLa 3000-323-006 (Os/09)t^r Cet urfttl.Page 4 of 5 \tt {' 6. Permit Validation: vehiclet and that the operate such equiprn AUTHORIZED EMERG ENCY VEHIC LE PERMIT ION RENEWAL and I has the appropriate authority as described in part 3 of this application to know of no reason why this application should be denied." .:' '1, {$\,_ l certify that: ', -'', ' , I ' , .'. . I ': '._ l:', '', . . ', a. , ' nil ct the information given i4 thiq application ig correct to the beit pf my knowiedge a4d provided in for niengftting purposes) of -each primary jurisdiction:iri which the vehicles ire to be used as authoriz-ed emergency vehicle(s), , . None of the drivers, to the best of my knowledge in the lai;t year, have been convicted ol nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane. Only the vehicle(s) and equipment listed in this application will be used as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the primary holder or executive officer in charge of overseeing this permit, I understand that if the permit is issued,'it is my responsibili$ to ensure: No driver listed in this permit uses the vehicle for private purposes unless all emergency equipment is removed or covered. No driver other than those listed under this approved permit operates the vehicle(s) listed unless all emergency equipment is rbmoved or covered. lf I wish to add a new driver or vehicle to this permit, l- must.ieceive pribr approvat before they are authorized under this permit. The driver must exercise due care and caution and must obey all traffic laws. list of approved if requested.; Signature Title (cHrEF Name Date c. 16, Ja I sgo-+ NOTE: onl authorizes L . Jurisdiction E-Mail:.. 3u" he, ,use of mption dev ngt.on SLate PatrolWashi (on. berny.@,wsp. wa. gov emergency light and siren lce is not author.ized on 3O0G323{O6 (Osrog) The ude of a signal pree Page 4 of 5 :. ,:, • x: R� ' � , � i . � R"8,9'8 LIFBP IOHN R. BAIISTE Chief{l...!RISTINE O. CREGOIRE Covernor Dear Mr. Bartel: Your renewal application for yourAuthorized.Ernerg.ency Vehicle Permit (AEVP) for the vehicles used byW;';ilg6ri6iiid fvfoiorcaOe nas-Ueei processed' Enclosed is an amended version of your renewal appd;i6;oullining thd equipment, operators and 6litli"pni;;*#i#t y"i ri;G neen approved to op-erate in. The amendments tro your application are as follows; December 14,2049 Mr. Steve Bartel Washington State Motorcade 44Og SW Admiral#102 ' Seattle WA 98116 STATE OFWASHINGTON nEC 2i 2fi0$ nce we receNe they will be Code of Washi (RCW) 46 61.035 states' vehicle, -ntauihorization-Whenourofficereceived2.Ghangestoemergency.equipmentauthon?Tl?]l^-,:t::i'"^:'^Yl,::::=:i'1#il'":"n':8,,itouffi's:;li'[*:1"S,'la*gi'iliiB+"':''tl1ril1{f*?d'l3Jl'on d..l;ffi'l;y ih;'ftii i,ir'Eoi"ii,rns-. bince this equipment was not listed, our office contacted each Chief wfro prwiOea Lunorizdtidn for vour company to ' #6;il;ir1#v;#ffi e;'t:fi iii;',,:3;F,ffi Bt??g',l1fi il,f ?ilsf ;,I|ffi [lLH'that authorized thB,Y,sj,^T " t's ""'#?H#-:l q:vrsc v ine city of Enumclaw and MountlakeTerrale, Therefore, the use of a signal Preemption Qgvjce is.prohibited in all other areas tisted on your G';fr',t: litriitgrh"e ;Gi";qid"ry1ition indicatins that the sisnal preemption Oevice'it nii-.g ,t"i-lt i[#;-r;;1,^it may be cause for us to rgvoke your permr '" ;ffi'i;;;"*iih WAc to+-3e-oz'o' t ' ' 3 s.#" Page 2 Mr. Bartel December l4,2OO9 aso.n mvg Therefore, the. reterence to RCW 46.61.035 under authority has been removedfrorn your application. -' - '-' - - 4' Q.hanggs to.operators- You must list all operators on your renewal apptication, 9i199 t!e. opspalers werenot risted, we e-maired you *it'h-fi'" I,;ffi [Si"tapproveg o.p.erators our office has on file. Basedbn your response e:maii we willremove Patric Keily and James Wright tiom ioui fifilit. '5' Geographic areas not authorized - You are only authorized to use vourem q.rg gpy eq uipment with in the j urisd ictio ns ouuineJ lnln is i ir-encEi - -' appllcallon. ln order_to be authorized to operate in the other geographic areasyo..Y Jisted;authorization must be qranted fiom ihe;'hi6t t"* enforcement officerwithin thatjurisdiction. rrvrw'rrvr'r t Please also note tha!.in orderto operate on state routes and interstates you arerequired.to obtain a signature(s) through ihe-w;hifiio-ntt"t" patrol. tn order lliff igltll.f "H,i""t:",i:it""tr,fl':iiy,'t-llaig,anlli;ix#di"i"","gauthorization from the local Washington Siate Fltr6l cji't"ins for the arElJwhich youwoutd tike to use your emtrgengi_Lilffi""tfi JnviutirrlienE-wars.Below for your convenience is the con6c irirordnitiJn'iiri ihese DistrictGommanders: District ! (fiercgcounty).- captain Jeff DeVere (253) s36-6210. Pistrict 3 f [Ig countv)i - captbin steve Bur; \iril'4o1 :ti o i -' Districr 7,LsffJlglish,'skasir and KiGip countieEii cabt'aii ken Ginnard: {3tt()) 651-6337: 'li'ffi3fi'-'Jlfl"' : Please ensure a copy of th.is permit is caii'ied in each vehicle at all.times. Approximately 'one month prior to th-e expiration date, a renewairoim'*iiiue sent to you. ' , : lf you have any questions please call Ms. Melissa Van Gorkom at (360) 5964017. ndards Department at'r {r AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL WASHINGTON STATE PATROL EOUIPMENT & STANDARDS REVIEW UNIT GENERAL ADMINISTRATION BLDG PO BOX 42600 oLYMP|A WA 98504-2600 DATE AppROVED. Decembe r L4 , 2009 VALID UNTIL:November 8, 2OT0 CAPTAIN , (For nt Use Only) This application must be submitted by the Chief Executive the firm or corporation makin application Ptease type or print in ink. Address '{qo? S rq./ #/a> Slate t l,4 Zip ; Phone ( zas ) /.?2'2 Ff a E-mail <?f ^-/-t 2o:7 D u4.c. c. h-t 1. Vehicle lnformation: List all vehicles being used as authorized emergency vehicles. For ebcn vehicle, provide both the vehicle and emergency equipment information as outlined below. Any new vehicles-or vehicles with equipment installed other than what is authorized on the current permit for that vehicle-mUst receive prior approval before being utilized under this permit. IAMP COLOR(S) LAMP MAKEA'ODEL OTHER EQUIPMENT: OTIiER EQUIPMENT: uthlqr EMERGENCY EQUIPMENT INFORMATION MAKEINSTALLED MO i.. . :'VEHIG LE TION 74 o76i l/lDrFilu tz ?Ycv*lr LICENSE NO. VIN MAKE MODEL YEAR : 2oe 7. .'l;o l ,: :;lir..: REGISTERED CNA'NERJferer. Eu-frt VEHICLE INFORMATION YEAR LICENSE NO. Aqoq 3fl o t 31 MAKE MODEL N lltPlFnt tLtrY6tS REGTSTERED OWNER ff ,n o1; c ,uo// Reol. ,.tLAMP COLOR(S) LAMP 3OOG32$006 (05/09).Page 1 ofS AUTHORIZED EMERGENCY VEHICLE PERMIT. APPLICATION RENEWAL \t53 OTHER EQUIPMENT: VEH|CLE INFORMATION . 4. YEAR 2J'p -LICENSE NO.]:€4 ?o75 MAKE MODEL #ru'/., OWNER . ,'..:.i J. ,,AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL ilisii-nffiBFEFffiWF i z. purpose of Application:. Describe the.specific purpose for which the vehicle(s) shall be used as authorizeo LrLigency vehicle(s) and what neCessitates the vehicles' registration as emergency vehicles. Eiplain tne nature and scope of the duties, responsibility, and intended use of emergency equipment. 3. AuthoritY: ExPlain outlined u statute (Revised ington) that the vehicles' operators to use emergency equipment for the purpose outlined under part 2 of this application 4. Geographic Area: Check which tYPes of roads You will be operating on and state the specific geographic area(s) in which the vehicles shall be used as authorized emergency vehicles (city, countY, etc.). is required under. part 7 of this application.) ilaf?/ ,.t-ee aZ in o on\V 4l..rt+roYi"e.s \tog.trrcr,t vtqlrc c{lqlrgC tF lnq6 cort! ,u;f{ote of ft-uqenizg o(c n f cv! at f ,o ftc* V6.72 t2 d tv1 t] StateRoutes/lnterstates I .i* '"iFA..,oi tl"*i 'r*'n to have operating the vehicle(s) listed in this application new since your last a (Llse rtt.: '. OPERATOR/DRIVER NEWOPERATOR/DRIVER ' NEWOPERATOR/DRMER'NEVII u tr tr D tr tr tr n tr D n D u D n n tr D tr fl unS Fnr+et. S tPrtP/n 30oc323{06 (OyOg) 4{... 4s '*i".,,.0,,..-t';,.;!.1.".1' eJ Page 3 of 5 AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL FIF"JAMWK ti 6. Permit Validation: I certify that a. All of the information given in this application is correct to the best of my knowledge and provided in its full format to the undersigned chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes) of each primary jurisdiction in which the vehicles are to be used as authorized emergency vehicle(s). b. None of the drivers, to the best of my knowledge in the last year, have been convicted of, nor served any sentences or periods of probation for any felonies, nor arrested and convicted of a drug or alcohol violation or illegal use or possession of drugs, nor been required to register as a sex offender, nor have any of them been adjudicated incompetent or insane. c. Only the vehicle(s) and equipment listed in this application will be used as outlined in this application, and that only the operators listed under this permit will drive the vehicle(s). As the primary holder or executive officer in charge of overseeing this permit, I understand that if the permit is issued, it is my responsibility to ensure: a. No driver listed in this permit uses the vehicle for private purposes unless allemergency equipment is, removed or covered.- "'--:.- '- '. ;)-r' {' ' b. . No drjver: bther than ihose lisled under thjg adproved permit operates the vehicle(s) listed unless all' emEfjenby eQuipineht is renioveo or covbied.' tri wis'n to add a new driver or veniip to this permit, I must receive prior approval before they are authorized under this permit. c. The driver must exercise due care and caution and must obey all traffic laws. I understand that the inappropriate or misuse of authorized emergency vehictes may result in criminalor civil liability as well as cancellation of this permit as outlined under chapter 204-36 WAC. , tn addition, I understand that it is my responsibility to ensure that a copy of this permit and list of approved drivers are present in each vehicle at alltimes and must be presented to law enforcement, if requested. Signature Title (cHrEF Pate 7 :' Certification: This renewal application forAuthorized Emergency Vehicle Permits will not be accepted unless CERTIFIED by the chief law enforcement officer or fire chief (if the vehicle is to be used for firefighting purposes)-of each primary jurisdiction in which the vehiclds are to be used as authon?ed emergency vehicles (see part 4 of this application). lf the application is made by the chief of a law enforcement agency or fire department, it must be CERTIFIED by the head of the political sub-division. The certification must contain the following language: Signature \t Jurisdiction Phone (Van C2o' ,t?o(a E-Mail Nob clJrlr{nonee^ Htre u^€ ot-trEe drr->i e€ rs h n[ a.m€l.Brrorr. T'nrg, u-ri*lai n, Page 4 of53OOG323-006 (05/q9)::\rureot olvq u\rnrts. ;II? , illil', i: ,jif,L'*;- - bwlit-nof be accepte'd7. Gertification: this?enewit apptication ior Authori?-id emaroencv Vbhicle Pelmltr untess cERTtFtED by the chief taw "ni irl"#nion"Lior nrE cn-iLr (if the vehicle is to be used for firefighting prrporeJl'ot each primaryi;ffii-# ii *hi"n n" uuniCtis are to be used as authorized :xi#j[BJi:[':ff,ffil81;""#Hift'Jla't"JtjgHf,i''JJ"#ll"tglt'?il",i?'"'xJ?,|31,3-5#,'on 'nu iuttiiilltion mult cdntain the following language: Page 4 of 5 300{}323-006 (05/og) Please Signature Name (Please Print): Phone V!"lA P-^\4 outy \\rn^rs' Date 10-l.e-09 Title Ctief of Police 7 of PoliceJurisdiction E-Mail ' Page 4 of 5 3ooCa23-o06 (o5ro9) or U Signatu Name (Please Print) Phone Ne{€'on 3o0o-i23-0o6 (ot09) (YLi-) ??l ,al'o[ Please tYPe Signatu Name (Pleeso P.int) Phone (qzf|-54-6{n Cur,t{nortze S D Co C),a I Page 4 of 5 Date lo oiel Title DX Purl CilrE F. Jurisdiction f ze ott't 4 nn\ l,n.L ee i ,"r,.i"#"d&.u) U.tse\YP,lrbvE: V e t\-t li rnnte' 6t E-Mail k O.,tnd Page 4 of 5 ..' Please type or print: ltq Date E-Mail Title ,^ cp., 's A. l/evrzetuh,&)y ri onol.girer)*1nt- Page 4 of 5 Phone tslort€: 3000-323-006 et- c tH.,t \inr'v v tS. ,t r,yPe er Piln[ Signature Name (Please Frinl) Phone No+e:r93 )gss- t"tL t+Ft.r1t€* 3ooc323-Oo6 lbs/09) vPElAtr; 9r.fv1t sYurPtt Please type irr print: Signature Name (Pleas€ Printl Phone (| 7?./- lJ.t t E-Mail Date Jurisdiction,E",u"* t"sc.l E-Mail 6',',NQ (r', tqcf- crn. 4J 4. ( 9n\ls et \\ft\rr)\in Page 4 of 5 f,rrlrJ r E'€r9Lrrr wr{rInFrcPPlrw '. Title ffi,ssffirc rlts qjrlo{ si ren - 3000-323-006 (05/09) Please type or Signaturq Name (Pbas€ Prin0" Phone. (?>1 lgab NJO{e i. on\O.r \rypln-aeS u OP l4ent cr\i rni\S . |Jrease type or Signature Name (Please Prinl) Phone (' r*lolgi on ,Date lW4n 1ne Jurisdiction KPr* Page 4 of 5 fty Dunx{rilod- ,us €€ Qe de-r.rt Ltre Page 4 of 5 388-33/s:i E-Mail CLUir4^ltrtz€a t#te ue€ cF I ct"hat si re/n vh€14f,s 0r" '"'$,L300S323{06 (05/09)h @t;.ltlk'l Page 4 of 5 \(,.. AUTHORIZED EMERGENCY VEHICLE PERMIT APPLICATION RENEWAL \ Permit Validation: I certifY that: rforrnation oiven in thir :to the best of my knowledge and provided ina.Atloftheinforrnationgiveninthisapp.licationisconect . for firefightiftil;;#tbiq.gq prira*-iuriioiction in wh'rctr the vehictes are fo be used ,t b; Noneiof the drivers, to the best of my knowlgdge in.the last year, have been convicted of' nor served any ,"nt"rlr. ti.;*A;"f-p;"uaticinioi iny ietonies, nor irrested and convicted of a drug or alcohol violation oi iri"gar i.,se or pos'session of drugs', n9r been required to register as a sex offender, nor h;;;;y;f i#; neen ab;uoit"'* .'nto.To:':tt "t :T::"c. onry the vehicle(s) and equipment listed.in this application will be used as outlined in this application, . and that only tfrri ,ipJratori listed under this permitwill drive the vehicle(s). As the primary holder orexecutive officer in charge of overseeing this permit, I understand that if the permit is issued,'it is my respqnslbilrty to ensure: ' .. . - ., -. a. No.driver lisled in this permit uses the vehicle for private purposes unless all emergency equipment is removed or covered. b. No driver other than those listed under this approved permit operates the vehicle(s) listed unless all emergenei'6qliirm"nt is removeo Jr cou"nd' ti I wisn to add'a new driver or vehicle to this permit, l. must receVjiriSiappto"al before they are authorized under this permit. . - - -- - -ta L--4^ l^.-,.c. The driver must exercise due care and caution and must obey all traffa laws. ,:';:!: IP t