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ANKIETA - PROGRAM UŻYTKOWY DOMU - dla WŁODARCZYK PROJEKT
Imię i nazwisko Inwestora :
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Adres zamieszkania : ..................................................................................................................................................
Telefon , fax....................................................................e-mail.....................................................................................
Adres inwestycji , nr działki :
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Zainteresowania rodziny : :.........................................................................................................................................
Wielkość rodziny..........................................................................................................................................................
Inne osoby zamierzające mieszkać z Inwestorem : / np. dziadkowie , gosposia /
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INFORMACJE NA TEMAT PROJEKTOWANEGO DOMU :
1. Charakter domu : jednorodzinny , dwurodzinny, wielopokoleniowy, z usługami
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2. Piwnice / rodzaj pomieszczeń i orientacyjna powierzchnia użytkowa /
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3. Parter : / rodzaj pomieszczeń i orientacyjna powierzchnia użytkowa /
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4. Piętro :
- kondygnacja pełna
- kondygnacja w dachu
- rodzaje pomieszczeń i orientacyjna powierzchnia użytkowa :
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5. Charakter poszczególnych pomieszczeń :
a/ pokój dzienny – salon :
-wielkość / m2............................................................................................................................................................
- otwarty lub zamknięty na inne pomieszczenia
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-z kominkiem .................................................................................................................................................................
-TV................................................................................................................................................................................
- inne uwagi ...................................................................................................................................................................
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b/ kuchnia :
-wielkość / m2 : ..........................................................................................................................................................
-otwarta na pokój dzienny lub jadalnię : ........................................................................................................................
-zamknięta : .................................................................................................................................................................
-z miejscem do jedzenia / na ile osób / .......................................................................................................................
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-ze spiżarką / m2 /
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-inne uwagi
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c/ jadalnia :
-wielkość / m2 /
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-sposób połączenia z pokojem dziennym lub kuchnią
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-wielkość stołu / na ile osób /
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-inne uwagi
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d/ pokój kominkowy :
-wielkość /m2 /
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-inne uwagi
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e/ hall :
-wielkość / m2 /
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-otwarty lub zamknięty na inne pomieszczenia :
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-z garderobą lub szafami wbudowanymi .......................................................................................................................
-inne uwagi ....................................................................................................................................................................
f/ wiatrołap :
-wielkość / m2..................................................................................................................................................................
- z szafami lub bez szaf................................................................................................................................................
-drzwi wejściowe / 1 skrzydło , 2 skrzydła lub 1,5 /
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-inne uwagi ....................................................................................................................................................................
g/ schody wewnętrzne :
-otwarte lub zamknięte
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- inne uwagi ...................................................................................................................................................................
h/ gabinet - biblioteka / pokój do pracy / :
-wielkość / m2 / …..........................................................................................................................................................
-inne uwagi ....................................................................................................................................................................
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i/ sypialnie :
-sypialnia 1- rodziców w m2.................................., z garderobą / bez , z łazienką / bez, z balkonem / bez
-sypialnia 2 w m2..................................................., z garderobą / bez , z łazienką / bez, z balkonem / bez
-sypialnia 3 w m2..................................................., z garderobą / bez , z łazienką / bez, z balkonem / bez
-sypialnia 4 w m2..................................................., z garderobą / bez , z łazienką / bez, z balkonem / bez
-sypialnia 5 - gościnna w m2.................................., z garderobą / bez , z łazienką / bez, z balkonem / bez
-inne uwagi....................................................................................................................................................................
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j / łazienki :
-ilość...............................................................................................................................................................................
-wielkość / m2 / ..............................................................................................................................................................
wyposażenie ...................................................................................................................................................................
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-inne uwagi ....................................................................................................................................................................
k/ garaże :
- na ile samochodów osobowych ................................................................................................................................
-czy przewidywane są inne większe samochody ........................................................................................................
-wysokość / szerokość bramy........................................................................................................................................
-warsztat........................................................................................................................................................................
-miejsce na kosiarkę i inne narzędzia ogrodnicze .......................................................................................................
-ilość wrót garażowych..................................................................................................................................................
-inne uwagi ....................................................................................................................................................................
l/ kotłownia :
-rodzaj paliwa ................................................................................................................................................................
-inne uwagi ....................................................................................................................................................................
ł/ pomieszczenia gospodarcze :
-nazwa , ilość..................................................................................................................................................................
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-wielkość / m2 /
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-inne uwagi ....................................................................................................................................................................
m/ taras ogrodowy :
-wielkość ......................................................................................................................................................................
-częściowo zadaszony
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-z jakich pomieszczeń wyjście na taras
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n/ usługi :
-rodzaj ...........................................................................................................................................................................
-program + powierzchnia
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o/ upodobania Inwestora dotyczące wyglądu domu :
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p / dodatkowe wyposażenie domu :
-pochylnia , wyposażenie dla osób niepełnosprawnych ..............................................................................................
-ogród zimowy / oranżeria / ..........................................................................................................................................
-sauna ..........................................................................................................................................................................
-salka gimnastyczna .......................................................................................................................................................
-pokój bilardowy / rodzaj stołu / ....................................................................................................................................
-basen kryty ...................................................................................................................................................................
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-rozsuwane drzwi tarasowe ..........................................................................................................................................
-wbudowane w nadproże rolety okienne........................................................................................................................
-instalacje wewnętrzne specjalne :
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r/ materiały budowlane wraz z kolorystyką obiektu :
- ściany zewnętrzne / konstrukcja muru : 2 , 3 warstwowa /.
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- okna
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- drzwi
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- stropy
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- dach / pokrycie , kolor /.
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- cokoły ..........................................................................................................................................................................
s / klimat wnętrz :
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t / ogrodzenie :
-wys.:..............................................................................................................................................................................
-cokół.............................................................................................................................................................................
-furtka ............................................................................................................................................................................
-brama............................................................................................................................................................................
-śmietnik.........................................................................................................................................................................
u/ uwagi dotyczące zagospodarowania terenu działki:
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w/ instalacje wewnętrzne :
-sanitarne :...................................................................................................................................................................
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-elektryczne :...............................................................................................................................................................
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-inne :............................................................................................................................................................................
podpis ..............................................................................