Pittsburgh Tri-State NKBA
Designer: Student Designer
Kitchen Design Survey Form
Date: I May , 2015
Name: Dean & Barbara Newton
Residence: East Tennessee
Client 1: Dean
Client 2: Barbara
Notes: Contractor is Red Door Homes
General Client Information
1.
What type of project is this? New Construction
2.
Have you ever purchased a kitchen before? Yes
3.
When would you like to start the project? ASAP
4.
How much time do you / will you spend at the jobsite residence? 100%
5.
Has anyone else assisted you in preparing a design for the kitchen? Yes about 100 Students
6.
Do you plan on retaining an interior designer or architect to assist in the kitchen planning? No
7.
Do you have a specific builder/contractor or other subcontractor/specialist with whom you would like to work?
Complete the Project? August 2016
If so, Name: Red Door Homes
8.
What portion of the project, if any, will be your responsibility? Painting /Window Treatments
9.
What budget range have you established for your kitchen project? $20,000 – $35,000
10. How long do you intend to own the jobsite residence? Lifetime
a.
Is return on investment a primary concern? No
b.
Do you plan on renting the jobsite residence? No.
11. What family members will share in the final decision-making process? The two of us and four children
12. What do you dislike most about your present kitchen? The size of the kitchen, do not have easy access to spices and baking goods, need more
storage for cooking utensils, pots and pans, not space for eating area.
13. What do you like most about your present kitchen? Corner storage cabinets, plenty of drawer space, microwave off the counter (but not over the
range), kitchen has an open feeling,
14. Sustainable design ideas important to your family:
Energy efficient appliances: Energy Star appliances

Energy efficient lighting systems: Use of LED lighting

Areas for recycling waste incorporated into the plan: Trash and recycling cabinet
15. If you are building a new home:
a.
Are you able to relocate windows, doors or walls at this stage of construction? A window may be added; no doors can be
relocated/changed
b.
Are you able to relocate walls at this stage of construction? No
©2008 NKBA BMF8
Copyright 2008 by National Kitchen & Bath Association. All rights reserved. No part of this document may be reproduced in any form by Photostat, microfilm, xerography, or any other means, or
incorporated into any informational retrieval system, electronic or mechanical, or transmitted, in any form or by any means, without the prior consent of the copyright owner. The Pittsburgh Tri-State NKBA
Chapter has receive written authorization from NKBA headquarters to reproduce/reuse this document.
37940-1
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Specific Kitchen Questions
1.
How many household members? Are you planning on enlarging your family while living here?
Name
Age
Handed
44
36
13
11
9
6
Dean
Barbara
Sloan
Slade
Stone
Scout
2.
How many pets in your household? 1
3.
Do any frequent guests have physical limitations? No
4.
Personal information about the kitchen:
Height
R
L
R
L
R
L
R
L
R
L
R
L
R
L
Yes
No
Physical Limitations/Mobility Aids
5’7”
5’2”
What Types? Rhodesian Ridgeback (Dog)
Names: Sparky
What is the typical pattern of cooking in your household?
One person cooks and another person helps. Describe: We often have help in the kitchen preparing meals from the kids
What about clean-up?
Cooking and clean-up are shared. Describe: Children and guests help.
5.
Primary Cook:
Is the primary cook
left handed
right handed
Does the primary cook have any physical limitation?
Yes
No
How tall is the primary cook? 5’7”
Does the primary cook have any cooking hobbies/specialty cooking preferences?

gourmet
baking
grilling
bulk cooking to freeze

6.
Other Family Cooks:
How many other household members cook? 4
Who are they? Dean, Barbara, Sloan and Slade
Do they
have a cooking hobby
assist primary cook with specific task
share a menu item with primary cook?
Is a specialized cooking center required for the secondary cook? No
7.
How does the family use the kitchen for meals at home?
daily heat & serve meals
weekend family meals
daily “from scratch” meals
daily “bring in” meals
weekend “quantity” cooking
ethnic or specialty cooking (please specify)
What type of foods is the family cooking? Lasagnas, pastas, steaks, slow cooked items, pastries, muffins and deserts
8.
What are your kitchen dining area requests? Eating for six at 36inch height
Number of seated diners 6
9.
36” counter height
Is the kitchen a socializing space? Yes
10. What time of day is your kitchen most frequently used? Mornings and evenings
11. Do you have any furniture that you want in your kitchen?
Stools for a 36” counter
©2008 NKBA BMF8
Copyright 2008 by National Kitchen & Bath Association. All rights reserved. No part of this document may be reproduced in any form by Photostat, microfilm, xerography, or any other means, or
incorporated into any informational retrieval system, electronic or mechanical, or transmitted, in any form or by any means, without the prior consent of the copyright owner. The Pittsburgh Tri-State NKBA
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37940-1
2
12. How would you like the new kitchen to relate to adjacent rooms? The kitchen will open to a breakfast area which will have a large harvest table.
13. Do you entertain frequently? 3-5 times
per month-
formally
informally
buffet
plated
How many people typically might be in the kitchen when entertaining? 8-12 Do friends bring food to share?
Yes
No
14. Designing the kitchen so that it supports your entertainment style is part of the planning process. Tell me which statement fits you best:
I like my guests to be sitting in the kitchen visiting with me while I cook.
I like my guests to help me in the kitchen in meal preparation.
15. What secondary activities will take place in your kitchen?
Computer Usage
Hobbies:
Medicine Center / Use
Children Playing
Eating
Laundry
Message Center
Study/Homework
Growing Plants
Liquor/Wine Storage
Planning Desk
TV /Radio/Media/CD
16. What is your cycle for shopping for food?
Daily
Twice Weekly
17.
Weekly
Bi-weekly
Monthly
What types of products/materials do you purchase at the grocery/specialty store?
Predominantly fresh food purchased for a specific meal.
Predominantly fresh/frozen foods purchased for stock.
Traditional pantry boxed/packaged/canned/bottled goods purchased for stock.
Cleaning products stocked in bulk
Paper products stocked in bulk:
Other boxed/packaged food items stocked in bulk:
Other:
18. Where do you presently store:
BA Baking Equipment
BA Flatware
BA Leftover Containers
BA Serving Trays
T Boxed Goods
BA Food Prep Utensils
BA Linens/Towels
BA Specialty Cooking Vessels (Wok, etc.)
W Canned Goods
BA Food Wrapping Materials
BA Non-Refrigerated Fruits/Vegs
L Cleaning Supplies
W Glassware
T Paper Products
C Coffee Station
BA Grill Equipment
T Pet Food
BA Cooking Utensils
BA Hand Appliances
BA Pots & Pans
W Dishes
L Laundry/Iron Equip
BA Recycle Containers
Legend:
AG=Appliance Garage
B=Basement
BA=Base Cabinet
BC=Bookcase
C=Countertop
D=Desk
G=Garage
L=Laundry Room
P=Pantry Closet
T=Tall Cabinet
W=Wall Cabinet
©2008 NKBA BMF8
Copyright 2008 by National Kitchen & Bath Association. All rights reserved. No part of this document may be reproduced in any form by Photostat, microfilm, xerography, or any other means, or
incorporated into any informational retrieval system, electronic or mechanical, or transmitted, in any form or by any means, without the prior consent of the copyright owner. The Pittsburgh Tri-State NKBA
Chapter has receive written authorization from NKBA headquarters to reproduce/reuse this document.
37940-1
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19. What type of specialized storage is desired?
Bottles
Display Items
Linen
Wine
Bread Board
Dishes
Plasticware
Woven baskets for produce
Bread Box
Food Wrappings
Soft Drink Cans
Cookbooks
Glassware
Spice
Cutlery
Lids
Vegetables
20. What small specialty electrical appliances do you use in your kitchen?

Blender
Crock Pot / Slow Cooker
Mixer
Can Opener
Electric Frying Pan
Toaster
Coffee Grinder
Food Processor
Toaster Oven
Coffee Pot (Keurig)
Griddle
Wok
Countertop
Built-in
Waffle Maker
Juicer
21. Do you plan on sorting recyclable trash in your kitchen?
Yes
No
Number of bins required: 1
Would you like a sorting station in the:
Kitchen
Utility/Mud Room
Garage
Basement
Outside
Design Information
1.
What type of feeling would you like your new kitchen space to have? Have you created a scrapbook of notes, photos and ideas of
kitchens that you like?
Traditional (Shaker Style door) Waypoint Living Spaces #650S
2.
What colors do you like? Dark and warm colors
And dislike? Blue, Green
What colors are you considering for you new kitchen? Sandstone Cove by Behr (730C-2) and Espresso for the cabinets
What are the color preferences of other family members? Same
3.
Design Notes: The wall between the kitchen and breakfast room has been removed from the plan. An overhead beam will span the area
connecting the kitchen to the breakfast room. The space below the beam can be a half wall, cabinet back, or left open. There will be a 30 inch
range (will consider separate 36” cooktop and oven), single dishwasher, side-by-side refrigerator free standing, double bowl sink. Cabinets should
not exceed 96 inches above the floor. Work island or peninsula with eating space for at least six people. Sink and dishwasher can be in the island or
peninsula. 36 inch custom hood will be made by homeowner who is also a blacksmith, but should be designed by the kitchen designer (36 inch VentA-Hood blower and insert). Pantry Storage with roll-outs in tall cabinet. OK for cooking appliances in island or peninsula.
©2008 NKBA BMF8
Copyright 2008 by National Kitchen & Bath Association. All rights reserved. No part of this document may be reproduced in any form by Photostat, microfilm, xerography, or any other means, or
incorporated into any informational retrieval system, electronic or mechanical, or transmitted, in any form or by any means, without the prior consent of the copyright owner. The Pittsburgh Tri-State NKBA
Chapter has receive written authorization from NKBA headquarters to reproduce/reuse this document.
37940-1
4
Source
Cabinetry: Waypoint Living Spaces
Key: KS= Kitchen Specialist
Use Existing
O= Owner OA= Owners Agent
No
Face Material
Wood-Species
Door Style:
Furnished by
KS
O/OA
Base
Wall
Tall
Island
X
X
X
X
Maple
Installed by
KS
O/OA
Waypoint Living Spaces Style 650S
Espresso
Color and Finish:
Storage Accessories or Organizers:
Base
Wall
Tall
Island
Appliance Garage
Base
Breadbox
X
Pull-out Cutting
Board
Roll-out Cart
Cutlery Tray
X
Roll-out Shelf
Door Shelf
X
Spice Rack / Drawer
Drawer Divider / Insert
Swing-out Shelf
Drawer Dish Storage
Tilt-down Drawer
Drawer Pot / Pan
Storage
Knife Block
Towel Bar
Knife Drawer
X
Lazy Susan /
Turntable
Mixer Lift-up
X
Pantry
X
Plate Rack
Wall
Tall
Island
X
X
Trash Can
X
Tray Dividers
(Vertical)
Toe Kick Step Stool
X
Vegetable Bin /
Basket
Wide / Deep Drawer
X
X
Peg Board Drawer
Pot Rack
Other
Pull-out Recycle Bin
X
Other
Soffit / Fascia
Use Existing
N/A
Furnished by
KS
O/OA
Fascia / Soffit Construction
Open
Extended
Flush
Installed by
KS
O/OA
Fascia / Soffit Materials N/A
Recessed
Remove
None
©2008 NKBA BMF8
Copyright 2008 by National Kitchen & Bath Association. All rights reserved. No part of this document may be reproduced in any form by Photostat, microfilm, xerography, or any other means, or
incorporated into any informational retrieval system, electronic or mechanical, or transmitted, in any form or by any means, without the prior consent of the copyright owner. The Pittsburgh Tri-State NKBA
Chapter has receive written authorization from NKBA headquarters to reproduce/reuse this document.
37940-1
5
Countertops
Use Existing
Yes No
Material
Designers Option Within Budget
KS
Kitchen
Furnished by
O/OA
Island
Other
Installed by
KS
Edge Treatment
Ceramic Tile
Kitchen
O/OA
Island
Other
Thickness
Size
Shape:
Grout
Bevel
Concrete
Ogee
Engineered Stone
(quartz)
Granite
Bull Nose
Limestone
Square
Marble
Eased
Full
½ Full
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:
Color or Pattern:
Details:
Preparation:
Describe:
Decking:
Insert:
Sink
Use Existing
Yes
No
KS
Material
Cast Iron or Stainless
Number of Bowls
Two
Same Size
Color
Designers Pick
Details:
Sink #1
Sink #1
Sink #1

Furnished by
O/OA
Sink #2
Sink #2
Sink #2
Installed by
Sink #3
KS
Mounting
Under-Mount or Apron
Sink #1
x
O/OA
Sink #2
Sink #3
Sink #2
Sink #3
Sink #3
Sink #3
Strainer
Accessories
3
4
5
Faucet
Use Existing
Yes
No
Material
Brushed Nickel
KS
Sink #1
Furnished by
O/OA
Sink #2
Sink #3
KS
Style / Features
Goose Neck
Installed by
O/OA
Sink #1

©2008 NKBA BMF8
Copyright 2008 by National Kitchen & Bath Association. All rights reserved. No part of this document may be reproduced in any form by Photostat, microfilm, xerography, or any other means, or
incorporated into any informational retrieval system, electronic or mechanical, or transmitted, in any form or by any means, without the prior consent of the copyright owner. The Pittsburgh Tri-State NKBA
Chapter has receive written authorization from NKBA headquarters to reproduce/reuse this document.
37940-1
6
Lighting Systems
Use Existing
Yes
No
General
Furnished by
O/OA
KS
Incandescent
LED
Fluorescent
Xenon
Halogen
Fluorescent
Xenon
Decorative
Incandescent
Installed by
O/OA
KS
Ambient
Cove
Recessed
Pendant
Surface mtd.
Track
Incandescent
Halogen
Fluorescent
Other
Under Cabinet
Other
Incandescent
LED
Fluorescent
Xenon
Other
Appliance & Fixture Specifications - Option 2
Will consider 30” Range or 36” Cooktop and Oven
Range
Cooktop / Range Top
Use Existing
Yes No
New
Fuel
KS
Furnished by
O/OA
Existing Finish:
KS
Installed by
O/OA
Use Existing
Yes
No
Size:
New
Fuel
Electric Only
KS
Furnished by
O/OA
Existing Finish:
KS
Installed by
O/OA
Size:
Electric Only
Type
Free-Standing 
Integrated
Electric Surface Units
Conventional Coil 
Type
Free-Standing
Integrated
Electric Surface Units
Conventional Coil
Drop-In 
Slide-In
Professional Style
Solid Disk
(Electric Hob)
Magnetic Induction 
Halogen Unit 

Dual Size Unit 
Surface Controls
Electronic 
Conventional Knob 
Other Cooking Surface Features
Griddle 
Grill 
Oven Features
Electric Oven 
Convection Oven 
Gas Oven 
Pyrolytic (SelfCleaning) 
Controls:
Conventional Knob
Electronic 
Other Range Features
Range or Cook

top/oven as an
option
Sealed Glass
Ceramic 
Thermostatic
Controlled Unit 

Magnetic Induction
Solid Disk
(Electric Hob)
Halogen Unit
Dual Size Unit
Surface Controls
Electronic
Conventional Knob
Other Cooking Surface Features
Range or Cook top/oven as an
option


Broiler 
Other
Drop-In
Slide-In
Professional Style
Sealed Glass
Ceramic
Thermostatic
Controlled Unit
Griddle
Grill


Ventilation System
Use Existing
Yes
No
KS
Furnished by
O/OA
Hood
Match to Cooktop 
Custom Design by student
36” Hood Cover designed by
student and built by owner.
Vent-A-Hood blower
package.


Match to Cabinetry 
Slim Line / Telescoping 

Installed by
O/OA
KS
Ventilation System Installation
New Ductwork Needed
Space to Run Ductwork
Duct Termination

©2008 NKBA BMF8
Copyright 2008 by National Kitchen & Bath Association. All rights reserved. No part of this document may be reproduced in any form by Photostat, microfilm, xerography, or any other means, or
incorporated into any informational retrieval system, electronic or mechanical, or transmitted, in any form or by any means, without the prior consent of the copyright owner. The Pittsburgh Tri-State NKBA
Chapter has receive written authorization from NKBA headquarters to reproduce/reuse this document.
37940-1
7
Ovens
Microwave Oven
Use Existing
Yes
No
KS
Furnished by
O/OA
KS
Installed by
O/OA
Use Existing
Yes
No
Conventional
New
Existing Finish:
Size:

Configuration
Single
Double
Combo Micro / Oven 
Under-Counter Installation
Wall Installation
Convection CookingConvection CookingSteam Cooking 
elective
Gas
High-Speed Cooking
X Pyrolytic (Self-Cleaning)
Controls:
Conventional Knob
Electronic 
Other Features
KS
Furnished by
O/OA
Microwave Oven
New
Existing Finish:
Installation
Free-Standing
Configuration
Microwave-Ventilation Combo
KS
Installed by
O/OA
Size:

Boxed/Built-In
Integrated
Professional Style
Microwave-Convection Cooking
Features
Browning Element
Make sure microwave is off of counter.
Microwave-Light Cooking
Turntable
Refrigerator
Use Existing
Yes
Installed by
No
KS
O/OA
Type
Single Door Refrigerator
Single Door Freezer
Side by Side
Top Mount
Bottom Mount
Undercounter
Modular Units:
Refrigerator Drawers
Freezer Drawers
Freezer:
Upright
Chest
Installation
Free-Standing
Boxed-In
Integrated
Under-Counter
Decorative Panels
#1
X
Features
Ice Maker
Ice Dispenser (Door)
Mini-Door Access
Water Disp. (Outside)
LCD Screen
Other Features
#1
X
#1
#2
#3
#1
#2
#3
X
X
X
Other Cooling Appliances
Ice Maker
Wine Storage
Dishwasher
Use Existing
Yes
No
Type
Door
Drawers
Installation
Built-In
Integrated with Decorative
Panel to Match Cabinets
Stainless Steel
Color Front
Furnished by
Installed by
KS
O/OA
KS
#1
X
#2
#1
X
X (Optional)
#2
Interior Finish
Plastic
Stainless
Dishwasher Features
Adjustable Shelves
Flatware Trays
X
O/OA
#1
#2
#1
#2
Multiple Racks
Special Cycles
Stem Storage
©2008 NKBA BMF8
Copyright 2008 by National Kitchen & Bath Association. All rights reserved. No part of this document may be reproduced in any form by Photostat, microfilm, xerography, or any other means, or
incorporated into any informational retrieval system, electronic or mechanical, or transmitted, in any form or by any means, without the prior consent of the copyright owner. The Pittsburgh Tri-State NKBA
Chapter has receive written authorization from NKBA headquarters to reproduce/reuse this document.
37940-1
8
Other Appliances
Use Existing
Yes
Furnished by
No
KS
Installed by
O/OA
Type:
Built –In Small Appliances
Radio
Computer
Telephone
KS
Intercom
Television
O/OA
VCR / DVD
Other:
Warming Drawer
Other:
Washer / Dryer
Other:
End of Appliance & Fixture Specifications - Option 2
Flooring
Use Existing
Yes
No
Furnished by
O/OA
KS
Installed by
KS
O/OA
Floor Preparation
Floor Covering
Removal: New Floor
Material
Leveling:
Bamboo
Shim:
Laminate
Subfloor Material:
Carpet
Ceramic Tile
Cork
Linoleum
Vinyl-Sheet
Vinyl-Tile
Stone
Other:
Wood-Engineered
Wood
Underlayment:
Color or Pattern:
Baseboard Under Trim:
Describe:
Transition Treatment
Windows
No Windows in Kitchen – May Add One
Use Existing
Yes
No
Interior Wall Patch:
Doors
Use Existing
Yes
No
KS
Furnished by
O/OA
Installed by
O/OA
Sink Vent Relocation:
KS
Exterior Wall Patch:
No Doors in Kitchen Only Two Doorways [Plaster Returns]
KS
Furnished by
O/OA
Installed by
KS
Designers Option
Decorative Surfaces
Use Existing
Yes
No
Wall Preparation
KS
New Plaster/Drywall
Wall Finish
Paint
Ceiling Finish
Paint
Ceiling Preparation
New Plaster/Drywall
Furnished by
O/OA
Clean
Wallpaper
Wallpaper
Installed by
KS
Remove Exist. Covering:
Tile
Other:
Suspended
Clean
O/OA
Patch Exist
Vaulted
Patch Exist
Other:
Window Treatment
O/OA
Other:
Remove Exist. Covering:
Repairs:
Blinds
Fabric
Shutters
Other:








©2008 NKBA BMF8
Copyright 2008 by National Kitchen & Bath Association. All rights reserved. No part of this document may be reproduced in any form by Photostat, microfilm, xerography, or any other means, or
incorporated into any informational retrieval system, electronic or mechanical, or transmitted, in any form or by any means, without the prior consent of the copyright owner. The Pittsburgh Tri-State NKBA
Chapter has receive written authorization from NKBA headquarters to reproduce/reuse this document.
37940-1
9
Existing Construction Details
1. Age of Home: New home
2. Type of Neighborhood:
Rural
3. Type of Home:

Single Family
4. Structure of Home:
Two-Story (With basement)
5. Approximate Size of Home: 5,763 sq ft under roof
6. Style of Home (Exterior): Colonial salt-box design
7. Is the home historic?
Yes
No
8. Is the home part of a Homeowner’s Association?
9.
Yes
No
Style of Home (Interior) Traditional
Colors: warm colors
Materials: dry wall and wood
Furniture: traditional
10. Room Below Kitchen Unfinished basement
11. Condition of – New construction
12. Construction of Floor:
Slab
13. Direction of Floor Trusses:
14. Exterior:
Brick
15. Interior:
Drywall
Frame
Perpendicular to kitchen beam and front/rear of home. Joist Height: truss
Aluminum
Stucco
Lath & Plaster
16. Windows Can Be Changed:
Yes
Wood
Wood
Other: Hardiboard
Other:
No Doors Can Be Relocated:
Yes
No Walls Can Be Relocated:
Yes
No
17. Windows: None – May add one
18. Sewage System:
City Service
Septic System
19. Type of Roof Material: Asphalt shingles
©2008 NKBA BMF8
Other:
Age of Roof: New
10
Copyright 2008 by National Kitchen & Bath Association. All rights reserved. No part of this document may be reproduced in any form by Photostat, microfilm, xerography, or any other means, or
incorporated into any informational retrieval system, electronic or mechanical, or transmitted, in any form or by any means, without the prior consent of the copyright owner. The Pittsburgh Tri-State NKBA
Chapter has receive written authorization from NKBA headquarters to reproduce/reuse this document.
37940-1
Access:
Can Equipment Fit Into The Room? Yes
Basement: Yes
Attic: N/A
Material Storage: Basement
Crawl Space: N/A
Trash Collection Area: Side yard
HVAC: Describe Existing System: Heating: Central
Ventilation: Location TBD
Air Conditioning: Central
Plumbing:
Location of Existing Vent Stack: TBD
Type of Trap: P
Electrical
GFCI Existing:
Yes
New Wiring Access:
No
Hard
Average
Existing Electrical Service Capacity: 200
©2008 NKBA BMF8
Easy
Number of Circuits Open for Expansion: OK TBD
Number of 120V Circuits: OK TBD
Number of 240V Circuits: OK TBD
11
Copyright 2008 by National Kitchen & Bath Association. All rights reserved. No part of this document may be reproduced in any form by Photostat, microfilm, xerography, or any other means, or
incorporated into any informational retrieval system, electronic or mechanical, or transmitted, in any form or by any means, without the prior consent of the copyright owner. The Pittsburgh Tri-State NKBA
Chapter has receive written authorization from NKBA headquarters to reproduce/reuse this document.
37940-1