LIGHTING Inspection Report (D&L)

Existing Lighting Type: (please check all that apply)

Please Note Any Special Considerations:

Is A New Lighting Layout Requested:

What are the dimensions of the room:

Please list as W x L x Ceiling Height

Please Note All Requests:

Retrofit of existing fixtures:

Type of Existing Fixtures:

Please Note Any Special Considerations or Requests:

Upgrade existing fixtures:

How Many Rooms:

How Many Fixtures Per Room:

Please Note Any Special Considerations or Requests:

Would You Like Replace The Old Fixtures

What Is The Current Fixture Count:

List each room and the number of fixtures above.

Please Note Any Special Considerations or Requests:

What Lighting Output Do You Need:

Current Output:

Output Requested:

Color of Existing Lamps (Kelvin Rating):

Voltage (if varied please note what type in notes below):

Please Note Any Special Considerations or Requests:

Are There Existing Lighting Controls or Sensors:

What Type:

Are New Lighting Controls Requested:

What Type:

Are Motion Sensors Requested:

What Type:

Please Note Any Special Considerations or Requests:

Is There a Power Pole On Site:

Height of Pole:

Please include height measurement.

Color of Pole:

Style of Pole:

Take Photo: