Kitchen Design Survey FormMaterial Kitchen Island Other Edge Treatment Kitchen Island Other Ceramic...

1 ©2020 NKBA BMF8 Copyright 2020 by National Kitchen and Bath Association. NKBA is providing this material for general information only. This information does not constitute the provision of legal advice, accounting services, or professional consulting of any kind, nor should it be construed as such. Resources such as this business form are meant solely for informational purposes and use.

Designer:

Kitchen Design Survey Form

Date:

Name:

Residence:

Jobsite Address:

Client 1: Client 2:

Home Phone: Home Phone:

Work Phone: Work Phone:

Cell Phone: Cell Phone:

Email: Email:

Appointment Allied Professional

Schedule: Name:

Call When Ready: Firm:

Times Available: Address:

Directions: Office Phone:

Cell Phone:

Email:

Notes:

Company Name, Address, Email

©cb

General Client Information

1.How long do you intend to own the jobsite residence?

2. What do you dislike most about your present kitchen?

3..What do you like most about your present kitchen?

4. Sustainable design ideas important to your family:

Cabinets Counters Floors Building Materials Use of “Green” Products

Wood products supplied by environmentally responsible manufacturersSpecial water conservation products:

Energy efficient appliances:

Energy efficient lighting systems:

Sustainable design details incorporated into the plan:

Areas for recycling waste incorporated into the plan:

How old is the present kitchen? 5. When was the house built?

6. How many household members live in the home?

7

W

W

D

W

A

General products made from recycled materials:

Name Handed Age Physical Limitations/Mobility Aids

RR L

Height

RR L

RR L

RR L

RR L

RR L

2 2020 NKBA BMF8 Copyright 2020 by National Kitchen and Bath Association. NKBA is providing this material for general information only. This information does not onstitute the provision of legal advice, accounting services, or professional consulting of any kind, nor should it be construed as such. Resources such as this usiness form are meant solely for informational purposes and use.

.Personal information about the kitchen:

hat type of cooking is done in the home?

ho is the main cook?

o you share or rotate cooks?

ho does most of the cleanup?

re there any specialty appliances needed?


8. How does the family use the kitchen for meals at home?daily “from scratch” meals daily “bring in” meals weekend “quantity” cooking daily heat & serve meals

weekend family meals ethnic or specialty cooking (please specify)

What type of foods is the family cooking?

9. What type of seating would you like?separate table- counter number of seated diners

30” counter height 36” counter height

10. Do you have any furniture or items you would like to consider in the design of the kitchen?

11. Do you entertain frequently?

12.What other activities will take place in your kitchen?

Hobbies: Medicine Center / Use Children Playing

Laundry Message Center Study/Homework

Liquor/Wine Storage Planning Desk TV /Radio/Media/CD

13. What is your cycle for shopping for food?

Daily Twice Weekly Weekly Bi-weekly Monthly

42” counter heightht

Computer Usage:

Eating:Growing Plants:

14. Style of Home (Exterior):

15. Is the home historic? YesYe No What time period? Wh

Are there historic covenants or restrictions affecting the home?cti

16. Is the home part of a Homeowner’s Association? YesYe No

Is there Homeowner’s Association covenants or restrictions affecting the home? YesYe No

17. Style of Home (Interior)

Colors:

Materials:

Furniture:

Accessories:

Other:


Source

Furnished by Installed by Key: KS= Kitchen Specialist

O= Owner OA= Owners Agent

Use Existing

Yes No KS O/OA KS O/OA

Construction Base Wall Tall Island Face Material Base Wall Tall Island

Framed Wood-Species

Frameless Laminate

Cabinet Style Paint

Full Overlay Acrylic

Partial Overlay Metal

Lip Other

Inset Door Style:

Hardware

Knob

Pull Color and Finish:

Finger Pull

Cabinetry

Design Information

Special Details:

5

Soffit / Fascia

Furnished by Installed by Use Existing


Fascia / Soffit Construction Fascia / Soffit Materials

Open Extended Flush Recessed Remove

Other

Wallpaper Wood Display Rail Paint Lighted Cornice Other

Countertops

Furnished by Installed by Use Existing Yes No KS O/OA KS O/OA

Material Kitchen Island Other Edge Treatment Kitchen Island Other

Ceramic Tile Thickness

Size Shape:

Grout Bevel

Concrete Ogee

Engineered Stone (quartz)

Bull Nose Full

Granite ½ Full

Limestone Square

Marble Eased

Plastic Laminate Contrast Color

Stainless Steel Other

Soapstone Backsplash Solid Surface Match to Counter

Wood Full Height

Other Endsplash 4” High

Other Color or Pattern:

Other Details:

To Ceiling

©2020 NKBA BMF8 Copyright 2020 by National Kitchen and Bath Association. NKBA is providing this material for general information only. This information does not constitute the provision of legal advice, accounting services, or professional consulting of any kind, nor should it be construed as such. Resources such as this business form are meant solely for informational purposes and use.


Sink Furnished by Installed by Use Existing

Yes No KS O/OA KS O/OAMaterial Sink #1 Sink #2 Sink #3 Mounting Sink #1 Sink #2 Sink #3Composite Self-Rimming Enamel / Cast Iron Under-Mount Porcelain / Steel Integral Stainless Steel Counter Section Solid Surface Apron Other Other Other Special Features Sink #1 Sink #2 Sink #3Number of Bowls Sink #1 Sink #2 Sink #3 Drainboard L One Drainboard R Two Strainer

Same Size Accessories Large / Small 1

Three 2 Color Sink #1 Sink #2 Sink #3 3

4 Details: 5

Faucet Furnished by Installed by Use Existing

Yes No KS O/OA KS O/OAMaterial Sink #1 Sink #2 Sink #3 Style / Features Sink #1 Sink #2 Sink #3Brass One Handle L R

Chrome Two-Handles Epoxy-Color Bridge Type Gold Pot Filler Brushed Nickel Goose Neck

Pewter Pull-out Spray Stainless Steel Automatic Operation Other Other Features Sink #1 Sink #2 Sink#3

Other Separate Spray Other Instant Hot Other Water Filter Other Dishwasher Air Gap

Dispensers Furnished by Installed by Use Existing

Yes No KS O/OA KS O/OAType Sink #1 Sink #2 Sink #3 Type Sink #1 Sink #2 Sink #3 Dish Detergent Hand Soap

Hand Lotion

Lighting Systems Furnished by Installed by Use Existing

Yes No KS O/OA KS O/OAGeneral Ambient

LED Halogen Fluorescent Xenon Cove Recessed Pendant Surface mtd.

Decorative Track LED Halogen Fluorescent

LED Halogen Fluorescent Xenon Other

Under Cabinet Other

LED Halogen Fluorescent Xenon Other

Bowl Size

Type Finish


Appliance & Fixture Specifications - Option 1 (Option 1 to be used by design professionals who select specific appliances for the client.)

End Appliance & Fixture Specifications - Option 1

Size Color Item / Description Manufacturer Model # Notes

Surface Cooking Configuration: P=Professional CT=Cooktop (controls on top) RT=Range Top (controls on front)

Style: DI = Drop-in FS=Freestanding SI = Slide-in

Range Config. Fuel

Cooktop Config. Fuel

Rangetop Config. Fuel

Surface Ventilation Remote Blower Interior Blower Recirculate CFM Height Transition

Hood: Wall Mounted Island

Duct Cover:

Hood Liner and/or Blower:

Down Draft:

Micro Combo:

Oven Cooking

Oven: Single Double

Oven / Microwave Combo

Warming Drawer Quantity:

Microwave and Specialty Ovens Configuration: CT= Countertop BI= Built-In OTR= Over The Range

Microwave Confiig.

Trim Kit:

Other: Refrigeration Configuration: SxS= Side-by-Side UCDR= Undercounter Drawers UCD= Undercounter Door L/R TF= Top Freezer BF=Bottom Freezer

Style: Free Standing BI= Built-In (Standard) IN=Built-In (Integrated) AR=All Refrigerator AF=All Freezer

Refrig. Config Style:



Front Panel

Dishwasher / Compactor Style: ST= Standard IN= Integrated SI= Semi-Integrated DR=Drawer

Dishwasher Style

Compactor Style

Front Panel

Water Products Configuration: S= Single D=Double BL= Big and Little Style: UM= Undermount TM= Top Mount IN= Intergral AP= Apron C=Counter Section

Sink #1 Config Style

Faucet:


Faucet:


Faucet:

Sink Accessories:

Instant Hot:

Water Filter:

Garbage Disposer Quantity

Miscellaneous (Laundry, BBQ / Outdoor Equip, Intercom, Vacuum, Espresso, Ironing Center, Water Softener, Warranty, Icemaker, etc.)


Appliance & Fixture Specifications - Option 2 (Option 2 is used by designers who gather all generic appliance info., rather than specifying specific appliances.)

Range Cooktop / Range Top



New Existing Finish: Size: New Existing Finish: Size: Fuel Fuel

Electricity Natural Gas Electricity Natural Gas Propane Propane

Type Type Free-Standing Drop-In Slide-In Free-Standing Drop-In Slide-In Integrated Professional Style Integrated Professional Style

Electric Surface Units Electric Surface Units Conventional Coil Solid Disk

(Electric Hob)Sealed Glass

Ceramic Conventional Coil Solid Disk

(Electric Hob) Sealed Glass

Ceramic Magnetic Induction Halogen Unit Thermostatic

Controlled Unit Magnetic Induction Halogen Unit Thermostatic

Controlled Unit Dual Size Unit Dual Size Unit

Gas Surface Units Gas Surface Units Open-Air (Conventional) Sealed High BTU Open-Air (Conventional) Sealed High BTU

Surface Controls Surface Controls Electronic Conventional Knob Electronic Conventional Knob Griddle Grill

Other Cooking Surface Features Other Cooking Surface Features Griddle Grill

Oven Features Electric Oven Gas Oven Broiler Convection Oven Pyrolytic (Self-

Cleaning) Other

Controls: Conventional Knob Electronic Other Range Features

Ventilation System


Updraft / Canopy Downdraft / Proximity Exhaust Recirculating Surface Mount Pop-Up (Behind Cooktop) Pop-Up (Next to Cooktop)

Hood Ventilation System Installation Match to Cooktop Match to Cabinetry New Ductwork Needed Duct Termination Custom Design Slim Line / Telescoping Space to Run Ductwork

Ovens Microwave Oven

Furnished by Installed by Furnished by Installed by Use Existing Yes No KS O/OA KS O/OA

Use Existing Yes No KS O/OA KS O/OA

Conventional Microwave Oven

New Existing Finish: Size: New Existing Finish: Size: Configuration Installation

Single Double Combo Micro / Oven Free-Standing Boxed/Built-In Integrated

Under-Counter Installation Wall Installation Configuration

Convection Cooking- elective

Convection Cooking-Gas

Steam Cooking Microwave-Ventilation Combo Professional Style High-Speed Cooking

Pyrolytic (Self-Cleaning) Microwave-Convection Cooking Microwave-Light Cooking

Controls: Conventional Knob Electronic Features Other Features Browning Element Turntable


Refrigerator / Freezer



Type #1 #2 #3 Features #1 #2 #3 Single Door Refrigerator Ice Maker Single Door Freezer Refrigerator / Freezer:

Ice Dispenser (Door)

Side by Side Mini-Door Access Top Mount Water Disp. (Outside) Bottom Mount LCD Screen Undercounter

Modular Units: Refrigerator Drawers Other Features #1 #2 #3 Freezer Drawers

Freezer: Upright Chest

Installation #1 #2 #3 Other Cooling Appliances Free-Standing Ice Maker Wine Storage Boxed-In Integrated Under-Counter Decorative Panels

Dishwasher



Type #1 #2 Interior Finish #1 #2 Door Plastic Drawers Stainless Installation #1 #2 Dishwasher Features #1 #2 Built-In Adjustable Shelves Integrated with Decorative Panel to Match Cabinets

Flatware Trays

Stainless Steel Multiple Racks Color Front Special Cycles

Stem Storage

Other Clean-Up Appliances



Type #1 #2 #3 Type #1 #2 #3 Disposer: Trash Compactor Batch Feed Continuous Feed

Other Appliances



Type: Built –In Small Appliances Computer Intercom VCR / DVD Warming Drawer Washer / Dryer Radio Telephone Television Other: Other: Other:

End of Appliance & Fixture Specifications - Option 2

9

10©2020 NKBA BMF8 Copyright 2020 by National Kitchen and Bath Association. NKBA is providing this material for general information only. This information does not constitute the provision of legal advice, accounting services, or professional consulting of any kind, nor should it be construed as such. Resources such as this business form are meant solely for informational purposes and use.

Flooring


Floor Preparation

Removal: Material

Leveling: Bamboo Carpet Ceramic Tile Cork

Shim: Laminate Linoleum Vinyl-Sheet Vinyl-Tile

Subfloor Material: Wood Wood-Engineered Stone Other:

Underlayment: Color or Pattern:

Baseboard Under Trim:

Transition Treatment

Describe:

Windows Check all that apply. Slider = S Casement = C Double-Hung = DH Skylight = SL Bow = BO Bay = BA

Vinyl = V Aluminum = A Aluminum Clad = AC Wood = W Glass Block = GB Furnished by Installed by Use Existing

Yes No KS O/OA KS O/OAInterior Wall Patch: Exterior Wall Patch: Sink Vent Relocation:

Window # Configuration Size Screen or RelocateScreen: Yes No

Screen: Yes No

Screen: Yes No

Screen: Yes No

Screen: Yes No

Yes No

Doors Check all that apply. Bi-Fold = BF Slider = S Pocket = P French = F Swing = SW

Solid Core = SC Steel = ST Hollow Core = HC Furnished by Installed by Use Existing

Yes No KS O/OA KS O/OADoor # Configuration Hinge Size Screen or Relocate

L R Screen: Yes No

L R Screen: Yes No

L R Screen: Yes No

L R Screen: Yes No

L R Screen: Yes No

L R Screen: Yes No

Relocate: YYes No

Hardware Finish: Passage Privacy Knob Lever

(Note: Door hinging determined as you face door and open toward you.)

Surfaces


Wall Preparation New Plaster/Drywall Clean Patch Exist Remove Exist. Covering:

Wall Finish Paint Wallpaper Tile Other:

Ceiling Finish Paint Wallpaper Suspended Vaulted Other:

New Plaster/Drywall Clean Patch Exist Remove Exist. Covering: Ceiling Preparation

Other: Repairs:

Window Treatment Blinds Fabric Shutters Other:

Relocate Can windows be relocated?

Can doors be relocated?

Floor Covering


Construction Source Category

Responsibility Use Existing KS O/OA

HVAC

Details:

Yes No Air Conditioning System Age:

Planned Improvements:

Heating System Age:


Cooking Ventilation Ductwork Age:


Electrical Work

Details:

Yes

No New Service Panel:

Code Updates:

Modifications to Exist. Service:

Plumbing: Yes No New Rough-In Requirements:

New Drainage Requirements:

New Vent Stack Requirements:

Modifications to Exist. Lines:

General Carpentry Yes No

Reconstruction Work (Except as previously noted.)

Windows:

Doors:

Interior Walls:

Exterior Walls:

Cabinet Install. / Woodworking Trim Install:

Miscellaneous Work

Details:

Yes No Miscellaneous Work:

Building Permit(s):

Structural Engineering / Architectural Fees:

Inspection Fees:

Other:

HVAC/HEATING

Heating System: Fuel Source Type:

Cooling Ventilation: Relocate, Replace Existing

Wire Type:

Open Circuits:

Water Supply:

Waste Pipe Type:

Existing Wall:

Existing Trim:

Yes Yes

Yes

No

Yes No

Removal of Windows:

Removal of Ceiling:

Removal of Floor Covering:

Removal of Soffitts:

Removal of Debris:

Demolition Work:

12

Existing Construction Details- continued

18.Condition of –

(Parallel Wall to Within ¾)

Surface Walls

Floors:

Ceilings:

Soffit / Fascia:

Squareness of Corners:

Is there any hazardous material to be removed?

Slab Frame 19. Construction of Floor:

20. Direction of Floor Joists: Parallel to Longest Kitchen Wall

StuccoBrick Aluminum Wood

Perpendicular to Longest Kitchen Wall Joist Height:

Other:21. Exterior:

22. Interior: Drywall Lath & Plaster Wood Other:

Yes No Doors Can Be Relocated: Yes No Walls Can Be Relocated: Yes No

Sliders Skylights Casement Greenhouse Bow/Bay Other: 24. Windows:

25. Sewage System:

Double Hung

City Service Septic System Other:

26. Type of Roof Material: Age of Roof:

Access:

Attic: Crawl Space:

Trash Collection Area:

Can Equipment Fit Into The Room?

Basement:

Material Storage:

HVAC: Describe Existing System: Heating: Ventilation: Air Conditioning:

Plumbing:

Type of Trap: Location of Existing Vent Stack:

Add Additional Line:

Electrical

No GFCI Existing: Yes

New Wiring Access: Hard Average Easy Number of Circuits Open for Expansion:

Existing Electrical Service Capacity: Number of 120V Circuits: Number of 240V Circuits:

27. Room Below Kitchen


23. Windows Can Be Relocated:

Existing Construction Details

G

F E

D

C

B A

Doo

rs

No.


13

Existing Construction Details (continued)

I H

G

F

E D

C

B

A

Win

dow

s

No.


14

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