Assessor New Construction

ROLF F. KLEINHANS

Assessor
New Construction Cost Statement - Commercial
Owner Name:*

First NameLast Name
Address:*

Mailing Address

Property Address

CityState / Province

Postal / Zip Code
Fee Parcel (APN):*
Permit Number:*
Project Description: *
IMPORTANT

Our records indicate that a building permit was issued, or new construction has occurred on your property. New construction must be assessed upon completion or as partially complete on January 1 if not completed. Please complete and return this form within 15 days of receipt. The assessed value of the new construction will be based on information you provide, along with comparable cost and market data. Please include any documentation you believe will assist our office in valuing the new construction, including photos.
Project Timeline:
Has work started on this project?*

YesNo
If not, has this project been permanently abandoned?

YesNo
Start date:

MonthDayYear
Date
If project is complete, date of completion:

MonthDayYear
Date
If not complete, estimated % complete as of January 1st:
Type of Construction:*

New StructureAdditionDemolitionInterior Remodel/AlterationExterior Remodel/AlterationRepair or ReplacementOther
Structural and Exterior
Frame:

WoodSteelConcrete BlockConcrete Tilt-upOther
Foundation:

SlabRaisedOther
Roofing:

CompositionMetalTileOther
Exterior:

StuccoWoodConcreteMetalOther
Interior Structure and Finish: Stories
Total Building Height (ft):
Number of Stories:
Height per Story (ft):
Mezzanine
Interior Structure and Finish: Ceiling Finish
Ceiling Finish:

Exposed/OpenSuspendedSheetrock/PlasterOther
Interior Structure and Finish: Floor Finish
Carpet
Carpet (Area in sq ft):
Hardwood
Hardwood (Area in sq ft):
Vinyl
Vinyl (Area in sq ft):
Tile
Tile (Area in sq ft):
Concrete
Concrete (Area in sq ft):
Other
Other Floor Finish (Indicate Type and Area in sq ft):
Interior Structure and Finish: Roll Up Doors
Roll Up Doors - Quantity:
Roll Up Doors - Height (ft):
Roll Up Doors - Width (ft):
Interior Structure and Finish: Systems and Fixtures
Systems and Fixtures - Heating:

NewReplacement
Type of Heating:
Systems and Fixtures - Cooling:

NewReplacement
Type of Cooling:
Systems and Fixtures - Lighting:

NewReplacement
Type of Lighting
Systems and Fixtures - Sprinklers:

NewReplacement
Systems and Fixtures - Elevator:

NewReplacement
Other

NewReplacement
Other Systems and Fixtures:
Site Improvements:
Parking Lot
Parking Lot (sf):
Parking Lot # of Spaces:
Fencing
Fencing (length in ft):
Fencing Material:
Retaining Wall
Retaining Wall (length in ft)
Monument Sign
Other
Other Site Improvement:
Building and Tenant Information
1. Total Area of New Construction (sq ft):
Net Rental Area (sq ft):
2. The property is:

Owner-OccupiedLeased/Rented
Date of Lease:

MonthDayYear
Date
Lease Terms:
3. Use of Newly Constructed Area:
Office (sq ft):
Office Rental Rate:
Office Rental Rate:

ActualAnticipated
Retail (sq ft):
Retail Rental Rate:
Retail Retail Rate:

ActualAnticipated
Industrial (sq ft):
Industrial Rental Rate:
Industrial Rental Rate:

ActualAnticipated
Warehouse (sq ft):
Warehouse Rental Rate:
Warehouse Rental Rate:

ActualAnticipated
Other Newly Constructed Type Area (sq ft):
Other Newly Constructed Type Rental Rate:
Other Newly Constructed Type Rental Rate:

ActualAnticipated
4. Tenant pays:

UtilitiesInsuranceMaintenanceTaxesOther
5. Name of Tenant/Business:
6. Was the new construction paid for by tenant?

YesNo
Tenant paid a portion
Tenant-paid portion ($):
Is the tenant responsible for the property taxes for the new construction?

YesNoA portion is the tenant's responsibility
Cost Information

Please complete all applicable sections. If the item does not apply, indicate with "N/A". If an item has been included in another section, indicate in which section it is included. Please attach a copy of the itemized construction contract or invoices, if available.
Architectural and Engineering Fees:
Building Permits and Environmental Studies:
Site Preparation (site clearing. demolition, excavation. fill, grading, trenching. etc):
Building Cost (foundation, shell, roof, electrical, plumbing, heating and air conditioning, interior and exterior finish, built-in appliances, cabinets, painting, etc):
Exterior Additives (fencing. paving. retaining walls. other buildings, etc):
Landscaping (sprinklers, yard lights, lawns, shrubs, trees, etc):
Well, Pump, Tank, or Water Hook up:
Septic or Sewer Hook up:
Cost for Solar Improvements:
Carrying Charges during Construction (taxes, interest, insurance, etc):
Fees, Taxes, and Rentals (sewer connection, water meter, supervision, legal, equipment rental, sales tax, etc):
Contractor's Overhead and Profit:
Check if no contractor was used
Additional Labor and Material Costs not included above:
Total Construction Costs (as of date of completion, if incomplete as of January 1st of this year):
Remarks:
File Upload

Cancelof
This is a formal request for information made under California Revenue and Taxation Code Sections 441(d) and 470. The information provided will be held confidential under Section 408, except as permitted under Section 408.3. The Assessor's Office may contact you for additional information
Name*

First NameLast Name
Email*
example@example.com
Phone*
I certify that the foregoing and all infromation hereon, inclusing any accompanying statements or documenats, is true and correct to the best of my knowledge and belief.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

ROLF F. KLEINHANS