Assessor New Construction - New Manufactured Home

New Construction Cost Statement - New Manufactured Home

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 this form within 15 days. 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?

If no, has this project been permanently abandoned?

Start date:

MonthDayYear

If project is complete, date of completion:

MonthDayYear

If not complete, estimated % complete as of January 1st:

Exterior Detail

Walls:

Other

Roof Material:

Other

Manufactured Home Details

Manufacturer:

Year Built:

Foundation Type:

Is the home licensed?

License/Decal #:

Model:

Size (sq ft):

Kitchen

Kitchen Detail:

Kitchen Countertop Finish:

Kitchen Cabinet Material:

Kitchen Floor Covering Type:

Bathroom(s)

Showers?

Number of Showers:

Type of Shower Material:

Tubs?

Number of Tubs:

Type of Tub:

Stall Showers?

Number of Stall Showers:

Bathroom Countertop Finish:

Bathroom Floor Covering:

Room Count

Number of Bedrooms:

Number of Bathrooms:

Number of Offices:

Number of Family/Den Rooms:

Number of Other Rooms:

Heating and Air

Type of Heating and Air:

Other:

Number of Fireplaces:

Number of Woodstoves:

Site Improvements:

Asphalt/Paving?

Asphalt/Paving (Area in sq ft):

Concrete Patio?

Concrete Patio (Area in sq ft):

Deck?

Deck (Area in sq ft):

Deck Area:

Fencing?

Fencing Length (ft):

Fencing Material:

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.

Purchase Price:

Delivery and Installation Costs:

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:

Was contractor 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

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

Phone NumberFormat: (000) 000-0000.

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

Signature*

Date

MonthDayYear

ROLF F. KLEINHANS

Signature