1 ©20 20 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 2 ©20 20 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. 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” Produc ts Wood products supplied by environmentally responsible manufacturers Special 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? Name Handed Age Physical Limitations/Mobility Aids R R L H eight R R L R R L R R L R R L R R L 7. Personal information about the kitchen : What type of cooking is done in the home? Wh o is the main cook? Do you share or rotate cooks ? Who does most of the cleanup? Are there any specialty appliances needed? General products made from recycled materials: 3 ©20 20 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. 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 1 3. What is your cycle for shopping for food ? Daily Twice Weekly Weekly Bi-weekly Monthly 42 ” counter height ht Computer Usage : Eating: Growing Plants: 14. Style of Home (Exterior): 15. Is the home historic? Yes Ye 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? Yes Ye No Is there Homeowner’s Association covenants or restrictions affecting the home? Yes Ye No 17. Style of Home (Interior) Colors: Materials: Furniture: Accessories: Other: 4 ©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. 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 Yes No KS O/OA KS O/OA 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. 6 ©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/OA Material Sink #1 Sink #2 Sink #3 Mounting Sink #1 Sink #2 Sink #3 Composite 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 #3 Number 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/OA Material Sink #1 Sink #2 Sink #3 Style / Features Sink #1 Sink #2 Sink #3 Brass 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/OA Type 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/OA General 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 7 ©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. 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: Refrig. Config Style: 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: Sink #2 Config Style Faucet: Sink #3 Config Style 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.) 8 ©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. 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 Furnished by Installed by Use Existing Yes No KS O/OA KS O/OA Furnished by Installed by Use Existing Yes No KS O/OA KS O/OA 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 Furnished by Installed by Use Existing Yes No KS O/OA KS O/OA 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 ©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. Refrigerator / Freezer Furnished by Installed by Use Existing Yes No KS O/OA KS O/OA 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 Furnished by Installed by Use Existing Yes No KS O/OA KS O/OA 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 Furnished by Installed by Use Existing Yes No KS O/OA KS O/OA Type #1 #2 #3 Type #1 #2 #3 Disposer: Trash Compactor Batch Feed Continuous Feed Other Appliances Furnished by Installed by Use Existing Yes No KS O/OA KS O/OA 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 1 0 ©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 Furnished by Installed by Use Existing Yes No KS O/OA KS O/OA 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/OA Interior Wall Patch: Exterior Wall Patch: Sink Vent Relocation: Window # Configuration Size Screen or Relocate Screen: 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/OA Door # 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 : Y Y es No Hardware Finish: Passage Privacy Knob Lever (Note: Door hinging determined as you face door and open toward you.) Surfaces Furnished by Installed by Use Existing Yes No KS O/OA KS O/OA 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 1 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. Construction Source Category Responsibility Use Existing KS O/OA HVAC Details: Yes No Air Conditioning System Age: Planned Improvements: Heating System Age: Planned Improvements: Cooking Ventilation Ductwork Age: Planned Improvements: 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: 1 2 Existing Construction Details- continued 18. Condition of – (Parallel Wall to Within ¾) Surface Walls Floors: Ceilings: Soffit / Fascia: Squareness of Corners: I s there any hazardous material to be removed? Slab Frame 19. Construction of Floor: 20. Direction of Floor Joists : Parallel to Longest Kitchen Wall Stucco Brick 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 ©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. 23. Windows Can Be Relocated: Existing Construction Details G F E D C B A Doors No. ©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. 1 3 Existing Construction Details (continued) I H G F E D C B A Windows No. ©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. 1 4