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Receipt # <br />X <br />Contact Person <br />Cost of 1Nork Order <br />PUBLICWORKSDEPARTMENT � <br />UtiliHes Division, 3200 Cedar Street <br />Gvemtt WA 98201 <br />425-257-8800 <br />Cost of Service Order $16,516.90 <br />James Palda <br />Requested By Gordon Witcher <br />Property Owner (name) Steadfast Eve�ett Mall, LLC <br />Chazge Cost to (name if different than owner) <br />Date Paid <br />Vvork Order# <br />Scrvice Order # <br />Telephone # 949-623-7709 <br />Date of Request 03/17/10 <br />Address 4343 Von Karmen City Newport Beach, Zip 92660 <br />CA <br />Installalion LocaHon 1510 SE Everett Mall Way-3 <br />hislallation type/description/size/etc. 6" on 12" tap 17ft of 6" DI 675LA vault and 6" DCDA. <br />� The tollotving esHmate is Uased upon the UfiliHes Division paovid'uig all labor, equipment, <br />malerials, restoraHon, and fu�al hook-up. <br />Ple�se notifv lhe City of Lverett Utilitics Division 10 working days in advance of required installation <br />datc to allow for scheduling and parts procurement <br />Whenever the estimated cost is not sufficient to cover the total expense for labor, material, equipment rental and <br />administrative costs, lhe deficit shall Ue charged to the property for which such insW.t�tion was made and the <br />owner thcreof, and provided furthcr, that any excess payment shall be returned to the person applying for the <br />insLnllalion. <br />*Deposit must be paid prior to ordering parts or scheduling wark. <br />WATER METERS 3" AND LARGER MAY HAVE A SIX TO 10 WEEK LEAD TIME. <br />Dlateriai <br />Labor arv_' Benefits <br />Gquipmen� Rcntal <br />Tax <br />1'07'AL <br />8667.31 <br />5015.52 <br />2550.00 <br />284.07 <br />$16,516.90 <br />Prep�red by: Mike Ward ��C/ Datc �stimate Preparcd <br />Acccpted by: <br />Representing <br />ESTI117ATE GOOD ROR G 1110NTHS <br />cc: Bldg. Permit Center <br />Mark Sadler <br />Kirk Brooks <br />Gordon 1Nitcher <br />Matt Welborn <br />Mike 4Vard <br />Cli(I Lindman <br />Randy A(]en <br />03/76/10 <br />S:\;:Conmton\derical\Cosles[\2030\1510 S:-. Everett Mall lVay-3.DOC �/ 1 of 1 <br />N <br />