Page 1
Project Name:
Project Address:
Date:
Designer of Record:
Telephone:
Contact Person:
Telephone:
City:
Building Area
(ft)
Total
Common/Specific
Space Type
Space Area
(ft)
Total
Page 2
Project Name:
Contact Person:
Telephone:
Number of
Luminaires
Watts/
Luminaire
Total
Watts
Other
Low-Voltage Track
Line-Voltage Track
HID
Luminaire Description
(including number of lamps per fixture, watts per lamp, type of
ballast, type of fixture)
Incandescent
ID
Fluorescent
Type
Total
Area (ft)
Decorative
Display Lighting
Space ID
Unit Allowance
(W/ft)
Allowance
(W)
Luminaire
IDs
Installed
Power (W)
Page 3
Project Name:
Contact Person:
Telephone:
Number of
Luminaires
Watts/
Luminaire
Other
Low-Voltage Track
Line-Voltage Track
HID
Luminaire Description
(including number of lamps per fixture, watts per lamp, type
of ballast, type of fixture)
Fluorescent
ID
Incandescent
Type
Total
Allowance (building or
Lighting Power
Allowance (Watts)
Allowance (Watts)
Power Application
Lighting Power
(decorative or display)
Allowance (Watts)
Allowance (Watts)
Total
Watts
Page 4
Allowance
Tradable
Power
Allowance
Application
NonTradable
Power
Allowance
Non-Tradable Power
Allowance (Watts)
Additional Unrestricted
Lighting Power Allowance (Watts)
0.05
Luminaire Description (including number of lamps per fixture, watts per lamp, type of
ballast, type of fixture)
Number of
Luminaires
Watts/
Luminaire
Total
Watts
Total
Non-Tradable Application
Number of
Luminaires
Watts/
Luminaire
Total
Watts
+
Non-Tradable
Application
Tradable
Connected Lighting Power (Watts)
Non-Tradable Power
Allowance (Watts)
Non-Tradable
Connected Lighting Power (Watts)
+
+
+
Total Additional Allowance
Applied (sum of above) (Watts)