Assessor New Construction Cost Statement

ROLF D. KLEINHANS

Assessor
New Construction Cost Statement - Generic Form
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 no, 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:
Septic:
Septic Type:

N/AGravityPressure DoseSand FilterOther
Improvements:
Improvement Type:

N/APermanent Foundation for Manufactured HomePropane TankSolar
Propane Tank Size:
Solar Size:
Other New Construction:
Describe:
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 D. KLEINHANS