Designer:
Bath 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:
©2008 NKBA BMF9
Page 1 of 18
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.
37945-1
General Client Information 1.
What type of project is this?
Renovation
New Construction
2.
Have you ever purchased a bathroom before?
3.
When would you like to start the project?
4.
How much time do you / will you spend at the jobsite residence?
5.
How did you learn about our firm?
6.
Has anyone else assisted you in preparing a design for the bath?
7.
Do you plan on retaining an interior designer or architect to assist in the bath planning?
Yes
No Complete the Project?
If so, Name: 8.
Phone:
Do you have a specific builder / contractor or other subcontractor / specialist with whom you would like to work? Phone:
If so, Name: 9.
What portion of the project, if any, will be your responsibility?
10. What budget range have you established for your bath project? $5,000–$10,000
$10,000–$20,000
$20,000–$30,000
11. How long do you intend to own the jobsite residence? a.
Is return on investment a primary concern?
b.
Do you plan on renting the jobsite residence?
$30,000–$50,000
$50,000–$60,000
$60,000–$75,000
$75,000+
_________________________________________________________________
_________________________________________________________________________ _______________________________________________________________________
12. What family members will share in the final decision-making process? 13. Would you like our firm to assist you in securing project financing? 14. What do you dislike most about your present bath?
____________________________________________________ Yes
No
____________________________________________________________________
_________________________________________________________________________________________________________________ 15. What do you like most about your present bath?
______________________________________________________________________
_________________________________________________________________________________________________________________ 16. Sustainable design ideas important to your family: Use of “Green” Products
General products made from recycled materials:
Cabinets
Counters
Floors
Walls
Building Materials
Wood products supplied by environmentally responsible manufacturers Water usage: Water efficient fixtures:
Sustainable design details incorporated into the plan Toilet
Bathtub
Shower
Energy efficient lighting systems:
17. If you are remodeling: Is there a room addition planned?
Yes
No How old is the present bath?
a.
When was the house built?
b.
Are you considering relocating
windows
doors
_______________________________
walls in your new plan?
18. If you are building a new home: a.
Are you able to relocate
b.
Are you able to relocate walls at this stages of construction
windows
doors
19. Is there a view from the bathroom to be considered:
walls at this stage of construction? Yes
a.
Sun exposure
b.
From where in the bathroom should the view be visible?
c.
What about privacy?
©2008 NKBA BMF9
Yes
Yes
No
No
No
________________________________________________________________________________________________ Bathtub
Vanity
Shower
Other
___________________________
___________________________________________________________________________________________
Page 2 of 18
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.
37945-1
Specific Bath Questions 1.
Is this a
Master
Children
Other Family Member
2.
How many bathrooms are in the home?
3.
Who will use the bathroom?
4.
Characteristics of family members who use the bathroom: Are you planning on enlarging your family while living here? Yes
Special Area:
___________________________________ bathroom?
________________________________________________________________________________________
Name
5.
Guest
Age
Height
Handed
1.
R
L
2.
R
L
3.
R
L
4.
R
L
5.
R
L
No
Physical Limitations/Mobility Aids
Personal Information about the bathroom: a.
Will more than one person be using the bathroom at the same time?
How often?
b.
What types of bathroom activities can be done in a shared bathroom space?
c.
What types of bathroom activities need to be done in private?
d.
How important is auditory privacy?
______________________________________________
__________________________________________________________ Are bathroom noises a problem?
6.
Visitability:
a.
Will this bathroom be used by visitors to the home?
b.
Will the visitors be children or adults?
c.
Do any regular or frequent visitors have any physical limitation?
7.
Do you prefer separate showering and bathing areas?
8.
Would you like to consider a tub that will accommodate more than one person?
9.
Would you like to consider a shower that will accommodate more than one person?
Yes
No
__________________
How often?
__________________
_______________________________________________
_________________________________________________________________________________ _____________________________________________________________ _________________________________________________________________ ___________________________________________ ________________________________________
10. Do you prefer the water closet and/or bidet be separate from the other fixtures, and placed in its own compartment?
____________
11. Checklist for Bathroom activities: Grooming Activities Vanity / Lavatory Body:
Teeth: Nails: Cosmetics: Face: Hair:
First Aid: Hands:
Dressing Table
Location Bathtub
Person Shower
Other Room
Person #1
Person #2
Person #3
Washing Shave - Face Shave - Body Apply Lotion Hair washing Brush Floss Finger Toe Apply Remove Skin Care Blow Dry Brush / Style Color Cut / Trim Treating cuts and burns Apply Lotion Wash
Medicines / Vitamins: ©2008 NKBA BMF9
Page 3 of 18
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.
37945-1
Bathing / Showering Activities Bathtub Bathing:
Showering:
Sauna: Other:
Person
Location Shower
Other Room
Person #1
Person #2
Person #3
With Someone Assisting an Adult Bathing Pets Soaking / Relaxing With Someone Assisting an Adult Steam Showering Relaxing
Toileting Activities
Person Person #1
Person #2
Person #3
Assisting an Adult: Toileting: Personal Cleansing: Diaper Changing: Reading: Other Bathroom Activities
Location Vanity / Lavatory
Dressing Table
Bathtub
Person Shower
Other Room
Person #1
Person #2
Person #3
Display Collections Undressing / Hamper Dressing: Underwear / Sleep clothes Dressing: “Street” Clothes: Drink Beverages Eat Snacks Exercise w/o equipment Exercise using equipment Grow Plants Laundry: Air Dry Laundry: Hand-wash Laundry: Machine Wash Laundry: Sort / Fold Listen to Music Massage Meditation Personal Pampering Exercise Equipment Polish Shoes Read: Books / Newspapers Supervise Children Talk on Telephone Talking with People Tanning / Sunning Watch Television Other:
12. What appliances do you plan on using in the bathroom: Blowdryer Handheld Wall Mounted
Curling Iron
©2008 NKBA BMF9
Electrical Toothbrush
Radio/DVD/VCR
Valet
Electrical Razor
Television
Washer & Dryer
Fireplace Wood Burning Gas Hot Rollers
Towel Warmer Hydronic (hot water) Electric Scale
Other:
Other:
Page 4 of 18
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.
37945-1
Storage Checklist Item
User
Type of Equipment
Make-up Storage
(person #1)
Yes
No
(person #2)
Yes
No
Shaving Storage
(person #1)
Yes
No
(person #2)
Yes
No
Hair Grooming Equipment
(person #1)
Yes
No
(person #2)
Yes
No
Hand and Foot Grooming Equip (person #1)
Yes
No
(person #2)
Yes
No
(person #1)
Yes
No
(person #2)
Yes
No
Medicine / First Aid
Yes
No
Bathroom Paper Product Storage
Yes
No
Bath Towel Storage
Yes
No
Household Bedroom Linen
Yes
No
(person #1)
Yes
No
(person #2)
Yes
No
(person #3)
Yes
No
(person #4)
Yes
No
(person #1)
Yes
No
(person #2)
Yes
No
(person #3)
Yes
No
(person #4)
Yes
No
Pet Grooming / Bathing Area
Yes
No
Cleaning Supply Storage
Yes
No
Shoe Polishing Paraphernalia
Yes
No
Yes
No
Personal Hygiene Equipment
Personal Pampering Equip
Exercise Equipment
Other
Hanging Shoes Folded Clothing Accessories Hats
Other
Full Length Mirror Hanging Shoes Folded Clothing Accessories Hats Full Length Mirror
©2008 NKBA BMF9
Shelf / Drawer Space Required
Shelf Lengh:
# of Pairs
Boxed:
Double Pole: Yes
No
Single Pole:
Shelf Length:
# of Drawers / Pull- outs Yes Rack:
No Yes
Yes
No
Yes
No
Types: No
Boxes:
Wall Space for Racks: Yes
No
Shelf Length:
# of Pairs
Boxed:
Shelf Space:
Double Pole: Yes
No
Yes
No
Single Pole:
Shelf Length:
# of Drawers: Yes Rack: Yes
No Yes
Types: No
Boxes:
No
Page 5 of 18
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.
37945-1
Storage Checklist (Continued) Laundry Facilities
Yes Yes
Mini Kitchen
No No
Equipment Size: What Type of Equipment? Refrigerator Other: Other:
Bar Sink
Coffeemaker
Cooktop
Microwave
Other:
Design Information 1.
What type of feeling would you like your new bathroom space to have? Have you created a scrapbook of notes, photos and ideas of bathrooms that you like? American Country
Asian / Warm Contemporary
American Formal
Craftsman / Arts and Crafts
Old World European Personal Design Statement (Eclectic)
Sleek Contemporary Traditional
_________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ 2.
What colors do you like? And dislike?
3.
__________________________________________________________________________________________
_____________________________________________________________________________________________________
What colors are you considering for you new bathroom?
_______________________________________________________________
What are the color preferences of other family members?
_______________________________________________________________
Are there specific materials, fixtures, cabinetry or other features that you have pre-selected and want included in the project?
____
_________________________________________________________________________________________________________________ 4.
Design Notes:
____________________________________________________________________________________________________
_________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________
Special Details:
©2008 NKBA BMF9
Page 6 of 18
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.
37945-1
Cabinetry
Source
Key: BS= Bath Specialist O= Owner OA= Owners Agent Base Style
Wall
Use Existing Yes No Face Material
Tall
Furniture (Unfitted)
BS
Furnished by O/OA Base
BS
Installed by O/OA Wall Tall
Wood-Species
Built-In (Fitted)
Laminate Paint
Construction Framed
Acrylic
Frameless
Metal Other:
Door Type Full Overlay
Door Style
Partial Overlay Lip Inset
Hardware
Color and Finish
Knob Pull Finger Pull Material
Soffit / Fascia Use Existing Yes No BS Fascia / Soffit Construction Open
Extended
Flush
Furnished by O/OA Recessed
Installed by BS Fascia / Soffit Materials
Remove
Wallpaper
Other:
Cornice
Wood
Vanity
Use Existing Yes No Shower Walls
Tub Platform
Other
Concrete
Edge Treatment Thickness
Cultured Marble
Shape:
Decorative Laminate
Bevel
Engineered Stone (Quartz) Granite
Ogee
BS
BS
Installed by O/OA
Vanity
Shower Walls
Tub Platform
Other
Square Other: Backsplash
Grout
Height
Wood
End Splash Sides
Other Stone:
Countertop ext. over Water Closet Special Notes
©2008 NKBA BMF9
Furnished by O/OA
½ Full
Size
Special Notes
Lighted
Bull Nose Full
Marble Tile
Paint
Source
Key: BS= Bath Specialist O= Owner OA= Owners Agent
Solid Surface
Display Rail
Other:
Surfaces
Material
O/OA
Page 7 of 18
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.
37945-1
Bath Fixtures & Fittings - Water Closet Use Existing Yes
Furnished by
No
BS
Installed by
O/OA
1 Piece Low Profile Wall Hung Round Seat Comfort Height
BS
O/OA
2 Piece Standard Height Elongated Seat Other Other
Color: Seat: Trip Lever Finish: Stop & Supply Finish:
Bath Fixtures & Fittings - Bidet / Bidet Seat Use Existing Yes
Furnished by
No
BS
Installed by
O/OA
Vertical Spray Vacuum Breaker Horizontal Spray
BS
O/OA
Color: Faucet Finish:
Other: Other:
Bath Fixtures & Fittings - Bathtub Use Existing Yes
Furnished by
No
BS
Installed by
O/OA
BS
Material
O/OA
Placement
Cast Iron
Fiberglass
Steel
Acrylic
Ceramic Tile
Cult Marble
Type: Skirted
Right Drain
Fitting #1
Configuration Platform
Left Drain
Platform w/ Steps
Free Standing
Finish:
Location:
Finish:
Location:
Fitting #2 Type:
Bath Fixtures & Fittings - Shower Use Existing Yes
No
Furnished by BS
Installed by
O/OA
Fabricated
BS
O/OA
Fittings
1 Piece
Multiple Piece
Custom Shower Wall Material: Height:
Shower Floor/ Pan Material:
Valve Type:
Head Type:
Finish:
Shower #2
Valve Type:
Head Type:
Finish:
Shower #3
Valve Type:
Head Type:
Finish:
Shower #1
Bench Seat Material:
Shower #4- Body Sprays
Finish:
Shower #5- Hand-Held
Finish:
Diverter
Finish:
Configuration Drain
Finish:
Grooming
Bench
Size:
Other
©2008 NKBA BMF9
Recess:
Size:
Page 8 of 18
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.
37945-1
Bath Fixtures & Fittings - Lavatory Use Existing Yes
Furnished by
No
BS
Installed by
O/OA
BS
Material
O/OA Fittings
Porcelain
Glass
Cast Iron
4” Centers
Stainless Steel
Decorative Metal
Composition
Single Hole
Configuration
8” Centers Wall Mounted
Finish
Pedestal/Trap Cover Vessel
Rimmed
Self-Rimmed
Under-Counter Integral
Wall Hung
Other:
Ventilation Use Existing Yes
No
Furnished by BS
Fan
Installed by
O/OA Fan, Light (Combo)
BS
Fan, Light, Heat (Combo)
CFM Capacity:
O/OA Switch
Timer
Duct Work Space:
Heating Use Existing Yes
No
Furnished by BS
Auxiliary
Installed by
O/OA Timer
BS
O/OA
Placement:
Switch
Enclosures (Steam Door/s, Shower, Doors, Drapes, Etc.) Use Existing Yes
No
Furnished by BS
Installed by
O/OA
BS
O/OA
Tub
Finish:
Size:
Type:
Material:
Shower
Finish:
Size:
Type:
Material:
Steam
Finish:
Size:
Type:
Material:
Sauna
Finish:
Size:
Type:
Material:
Curtain Rod Finish:
Size:
Curtains (Color)
Size:
Light Fixtures Use Existing Yes
No
Furnished by BS
O/OA
General Incandescent
BS
O/OA
Ambient Halogen
Fluorescent
Xenon
Decorative Incandescent
Installed by
Halogen
Fluorescent
Xenon
Halogen
Fluorescent
Xenon
Cove
Recessed
Pendant
Track
Incandescent
Halogen
Surface Mounted Fluorescent
Special Details
Task Lighting Incandescent ©2008 NKBA BMF9
Page 9 of 18
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.
37945-1
Accessories Use Existing Yes
No
Glass Shelves
Medicine Cabinet
Furnished by BS
Installed by
O/OA
BS
Qty:
Support:
Finish:
Edge Treatment:
Qty:
Surface Mount
Finish:
O/OA Size:
Recessed
Size:
Mirror Size:
Mirror
Qty:
Surface Mount
Frame
Towel Bars
Qty:
Finish:
Size:
No:
Towel Rings
Qty:
Finish:
Size:
No:
Robe Hooks
Qty:
Finish:
Size:
No:
Tub Soap Dish
Qty:
Surface Mount
Recessed
Finish:
Placement:
Shower Soap Dish
Qty:
Surface Mount
Recessed
Finish:
Placement:
Bidet Soap Dish
Qty:
Surface Mount
Recessed
Finish:
Placement:
Lavatory Soap Dish
Qty:
Surface Mount
Recessed
Finish:
Placement:
Tub Grab Bars
Qty:
Finish:
Placement:
Toilet Grab Bars
Qty:
Finish:
Placement:
Paper Holder
Qty:
Surface Mount
Recessed
Finish:
Placement:
Magazine Rack
Qty:
Surface Mount
Recessed
Finish:
Placement:
Soap/Lotion Dispenser Tumbler Holder
Qty:
Finish:
Placement:
Qty:
Finish:
Placement:
Toothbrush Holder
Qty:
Finish:
Placement:
TV
Qty:
Finish:
Placement:
Sauna Use Existing Yes
No
Furnished by BS
Installed by
O/OA
BS
O/OA
Capacity:
Interior:
Style:
Heater:
Timer Location:
Wall Material:
Floor Material:
Other:
Steam Bath Use Existing Yes Tub
No Shower
©2008 NKBA BMF9
Furnished by
Installed by
BS
O/OA
BS
O/OA
Steam Generator Location:
Timer Location:
Wall Material:
Floor Material:
Page 10 of 18
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.
37945-1
Exercise Equipment Treadmill
Size:
Clearance Required: 30 sq. ft
Free Weights
Size:
Clearance Required: 20-30 sq. ft.
Bikes, Recumbent & Upright
Size:
Clearance Required: 10 sq. ft.
Rowing Machines
Size:
Clearance Required: 20 sq. ft.
Stair Climbers
Size:
Clearance Required: 10 to 20 sq. ft.
Ski Machines
Size:
Clearance Required: 25 sq. ft.
Single-Station Gym
Size:
Clearance Required: 35 sq. ft.
Multi-Station Gym
Size:
Clearance Required: 50 to 200 sq. ft.
Yoga Matte
Size:
Clearance Required:
Flooring Use Existing Yes
No
Furnished by BS
Installed by
O/OA
Floor Preparation Removal:
BS
O/OA
Floor Covering 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:
Describe:
Transition Treatment
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
Windows Use Existing Yes
Furnished by
No
BS
Interior Wall Patch: Window #
Configuration
©2008 NKBA BMF9
O/OA Exterior Wall Patch:
Installed by BS
O/OA Sink Vent Relocation:
New Windows Sizes Screen:
Yes
No
Screen:
Yes
No
Screen:
Yes
No
Screen:
Yes
No
Screen:
Yes
No
Screen:
Yes
No
Page 11 of 18
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.
37945-1
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
Doors Yes
No BS
Door #
O/OA
Configuration
BS
O/OA
Hinge
Size
Screen
Yes
No
Screen:
Yes
No
Yes
No
Screen:
Yes
No
Yes
No
Screen:
Yes
No
Yes
No
Screen:
Yes
No
Yes
No
Screen:
Yes
No
Yes
No
Screen:
Yes
No
Yes
No
Screen:
Yes
No
Yes
No
Screen:
Yes
No
Hardware Finish:
Passage
Privacy
Knob
Lever
Decorative Surfaces Use Existing Yes
No
Furnished by BS
Installed by
O/OA
BS
O/OA
Wall Preparation
New Plaster/Drywall
Clean
Patch Exist
Remove Exist. Covering:
Wall Finish
Paint
Wallpaper
Tile
Other
Ceiling Finish
Paint
Wallpaper
Ceiling Preparation
New Plaster / Drywall
Clean
Other: Window Treatment
Fabric
Shutters
Suspended Patch Exist Repairs:
Vaulted
Other:
Remove Existing Covering
Other:
Blinds
©2008 NKBA BMF9
Page 12 of 18
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.
37945-1
Construction
Source Use Existing
HVAC Details:
Category
Responsibility
BS
O / OA Air Conditioning System Age: Planned Improvements: Heating System Age: Planned Improvements: Bathroom Exhaust Fan Age: Planned Improvements:
Electrical Work:
New Service Panel: Code Updates: Modifications to Exist. Service: Heated Floor:
Yes
Heated Towel Bar: Plumbing:
No Yes
No
New Rough-In Requirements: New Drainage Requirements: New Vent Stack Requirements: Modifications to Exist. Lines:
General Carpentry:
Demolition Work Exist. Fixture and Equip. Removal: Trash Removal: Reconstruction Work (Except as previously noted.) Widows: Doors: Interior Walls: Exterior Walls: Insulated: Cabinet Install. / Trim-Out:
Miscellaneous Work:
Jobsite / Room Clean-up: Building Permits: Structural Engineering / Architectural Fees: Inspection Fees: Jobsite Delivery: Other:
©2008 NKBA BMF9
Page 13 of 18
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.
37945-1
Existing Construction Details 1. Age of Home:
Access Roads to Home: Elevator Size Limitations:
Delivery Truck Clearances: Through House
Access to Bath:
Exterior Access
2. Type of Neighborhood: Rural
Suburban
Urban
Historic
Mixed Use
Multi-Family
Gated Community
Planned Development
3. Type of Home: Single Family
Duplex
Townhouse
Condominium
Two-Story
Three-Story
Ranch
Apartment / Flat
Other:
4. Structure of Home: One Story
Split-Level
Split-Foyer/Raised Ranch
Other:
5. Approximate Size of Home: 6. Style of Home (Exterior): 7. Is the home historic?
Yes
No
What time period?
Are there historic covenants or restrictions affecting the home?
8. Is the home part of a Homeowner’s Association?
Yes
No
Are there Homeowner’s Association covenants or restrictions affecting the home?
9.
Yes
No
Style of Home (Interior) Colors: Materials: Furniture: Accessories: Other:
10. Room Below Bathroom
©2008 NKBA BMF9
Room Above Bathroom
Page 14 of 18
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.
37945-1
Existing Construction Details- continued 11. Condition of – Surface Walls Floors: Ceilings: Soffit/Fascia: Squareness of Corners:
Parallel Wall to Within ¾)
Is there any hazardous material to be removed? 12. Construction of Floor:
Slab
13. Direction of Floor Joists: 14. Exterior:
Brick
15. Interior:
Drywall
Parallel to Longest Bathroom Wall
Aluminum
Sliders
18. Sewage System:
Stucco
Lath & Plaster
16. Windows Can Be Changed: 17. Windows:
Frame
Yes
Wood No
Double-Hung
City Service
Wood
Perpendicular to Bathroom Longest Wall Joist Height: Other:
Other:
Doors Can Be Relocated: Skylights
Septic System
Casement
Yes
No
Greenhouse
Walls Can Be Relocated: Bow/Bay
Yes
No
Other:
Other:
19. Type of Roof Material:
Age of Roof
Access: Can Equipment Fit Into The Room? Basement:
Attic:
Material Storage:
Crawl Space: Trash Collection Area:
HVAC: Describe Existing System: Heating:
Ventilation:
Air Conditioning:
Plumbing: Location of Existing Vent Stack:
Type of Trap:
Add Additional Line:
Electrical GFCI Existing:
Yes
New Wiring Access:
No Hard
Average
Existing Electrical Service Capacity: ©2008 NKBA BMF9
Easy
Number of Open Circuits for Expansion: Number of 120V Circuits:
Number of 240V Circuits: Page 15 of 18
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.
37945-1
Existing Plumbing Center Lines
©2008 NKBA BMF9
Page 16 of 18
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.
37945-1
Existing Construction Details
©2008 NKBA BMF9
Page 17 of 18
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.
37945-1
Existing Mechanical Details
©2008 NKBA BMF9
Page 18 of 18
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.
37945-1