Form Rp-10 - Property Owner'S Statement Form - Assessor Los Angeles County Page 2

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Sample Sketch - Example Only
7 New Construction Layout (See sample sketch)
30
Diagram the new construction and show its exterior dimensions and location in relation
to other buildings on the lot.
New Construction
Family Room
15
Addition
20
40
Existing
20
Garage
25
Existing Home
STREET SIDE OF PROPERTY
Area Computation of New Construction
________ x ______ = ______
15
30
450
Area Computation of New Construction
________ x ________ = ________
________ x ________ = ________
________ x ________ = ________
________ x ________ = ________
________ x ________ = ________
________ x ________ = ________
Total Square Feet
= ________
Interior Detail of New Construction
o
Floor:
Carpet
o
o
Floor:
Wood
Other _______
o
o
Walls:
Drywall
Other _______
Exterior Detail of New Construction
o
o
Walls:
Brick
Siding
o
o
Stucco
Other ________
o
Roof:
Composition Roll
o
Composition Shingle
o
Gravel or Rock
STREET SIDE OF PROPERTY
o
o
Tile
Other ________
8 Remarks: Describe new construction and materials used, any work you did yourself,
Room Count
If addition or remodel, show number of
and any other new construction or demolition during the last 12 months.
rooms in main residence before and after
(Attach a separate sheet if necessary.)
completion.
Before
After
Bathrooms
_______
_______
Bedrooms
_______
_______
Dining
_______
_______
Family/Den
_______
_______
Kitchen
_______
_______
Living
_______
_______
Other
_______
_______
The Assessor’s Office audits statements for completeness and accuracy. We may contact you for additional
IMPORTANT
information or request a field check by an appraiser.
I declare under penalty of perjury that all of the foregoing statements, including any accompanying schedules and financial
statements, are to the best of my knowledge, true and correct.
Signature of Owner or Agent
Title
Date
Daytime Phone
(if agent)
If Owner/Builder,
o
Check Here
Street Address
City
State
ZIP
MAIL TO: Los Angeles County Assessor, 500 West Temple Street, Room 225, Los Angeles, CA 90012-2770
RP-10 (BACK) (REV. 12-14)

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