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BUILDING SAFETY DIVISION -
GAS OR ELECTRICAL UTILITY RELEASE FORM
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NO.
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ADDRESS
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UNITS
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�T**H..��ESE INSPECTIONS AREA RESULT OF: (CHECK ONE)
uNEW CONSTRUCTION ❑ REWIRING ❑ OTHER
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CMF 0)1146
( CITY OF COSTA MESA
BUILDING SAFETY DIVISION
GAS ELECTRICAL UTILITY RELE FORM
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CMF 077146
CITY OF COSTA MESA
BUILDING SAFETY DIVISION
GAS OR ELECTRICAL UTILITY RELEASE FORM
TRACT
LOT
ADDRESS
GAS
EMC.
NO.
UNITS
N0. METER
OUTLETS
NO. METERS
RELEASED
i
Y C/
THESE INSPECTIONS AREA RESULT OF: (CHECK ONE)
'06NEW CONSTRUCTION ❑ REWIRING ❑ OTHER (EXPLAIN)
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CMF 077146