Cook's Kitchen and Bath, Inc. - Diamond Certified Kitchen Remodeling, Bathroom Remodeling, Design, Installation - Vallejo, Concord, Danville, Benicia, Pleasant Hill, Pleasanton, Livermore, Dublin, Alamo, Walnut Creek, Hayward, Oakland, Bay Area, Contra Costa County, Solano County, Alemeda County, Napa, CA

Kitchens, Baths, Home Offices
and more!

707-342-2820 or 925-335-9099

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Authorized Dealers of

Huntwood Custom Cabinetry

Best Bath Systems

Featured Products

GROHE - Kitchen / Bathroom

Moen - Kitchen / Bathroom

TOTO - Bathroom / TOTO Toilets

Kohler - Kitchen / Bathroom

5 Star Rating with
We are a Better Business Bureau Accredited Business
Authorized Dealers of

Custom Cabinetry

Safe bathing for people of all abilities

We are a General Contractor with General Liability and Workman's Compensation Insurance. Lic. #835584

Kitchen & Bath Design Survey

(If you would rather fax or mail this form, download it in PDF format to print)

Name:		Home Phone:
Address:		Work Phone:
Job Site Address:		Mobile Phone:

Type of Remodel:

Kitchen Remodel

Bathroom Remodel

How did you hear about us?

Other (specify):

How much are you willing to invest?

Will cabinets be needed, and when?: Yes No

Are the cabinets to be delivered to the job site?: Yes No

Have you been to
a showroom yet?:
Yes No

When?:

Where?:

Number of people in your household? (Specify Adults and Children):

Number of Pets:

Handed?: Right Left

How tall are you?:

Do you enjoy cooking?
Yes No

Baking?
Yes No

Specialty Cooking?
Yes No

Canning?
Yes No

More than one cook?
Yes No

How often do you entertain?

Frequently

Occasionally

Never

Formally

Informally

Type of eating area desired:	Table size:
Number normally served at one time:

How often do you shop for food?:

Do you purchase any products in bulk?:

Where do you presently store your food and canned goods?:

Where do you presently store your tall cleaning and ironing equipment?:

What type of specialized storage do you desire? (choose below):

Kitchen		Bathroom
Pantry	Linen Storage	Pantry
Appliance Garage	Rollout Shelves	Cosmetic Organizers
Cutlery Dividers	Lazy Susan	Vanity Organizers
Tray Storage	Spice Storage	Laundry Hamper
Cookbook Storage	Bread Drawer	Mirror(s) How many?
Extra Breadboard	Tilt Out Trays	Safety Aids
Wine Rack	Knick Knack Shelves	Niches
Wine Glass Holder	Towel Rack	Shower Shelves
File Drawers	Pull Out Chopping Block	Towel Bars
Open Corner Shelves	Other Kitchen(specify above)	Other Bathroom (specify above)

What other activities will take place in your kitchen area? (choose below):

Eating	Wet Bar	Planning Desk	Sewing
Study Area	Laundry	Cake Decorating	Hobbies
Growing Plants	Other (specify above)

Can the location of doors and windows be changed it necessary?:

Appliance Information:

	Type	Make	Model	Measurements
Range
Cooktop
Wall Oven
Microwave
Hood
Dishwasher
Trash Compactor
Refrigerator
Sink
Other

What are you dissatisfied with in your present kitchen or bath?

What ideas do you have for your new kitchen or bath?

Do you have any sketches or pictures of ideas for your kitchen or bath?:	Yes No
Has anyone else done a kitchen or bath plan for you?	Yes No
Does your spouse entertain or cook in the kitchen?	Yes No
What does your spouse think of the new kitchen or bath?