elliptipar Applications Checklist

The following information is required so we may provide you with prompt and accurate design assistance.

PROJECT:

Name:
Location:
Specifier Name:		Firm:
E-mail:		Telephone:
		Fax:
Please check one of the following:
	Architect Engineer Interior Designer Lighting Designer Other
Representative:
Name:		Office:
Telephone:		Fax:

SPACE

Use/Function:
Structure:	wide X long X high
	Note: Non-rectangular spaces or those with irregular ceiling require dimensioned plan and section drawings.
Finishes:	Material	Reflectance	Matte	Semi-gloss	Specular
Ceiling		%
Walls		%
Floor		%
	Note: Skylights, trusses, beams, exposed ducts or other ceiling obstructions, and large wall openings or windows should be clearly defined on the plans, sections, and/or elevations. Include type of glass, finish on trusses, etc.

LIGHTING:

Preferred Sources:	Tungsten Halogen Fluorescent Metal Halide HPS LED
Luminaire Catalog No:
Mounting Height:	Above finished floor Below ceiling

Target Illumination Level:

(Footcandles average initial) fc at (above finished floor) inches

Total Light Loss Factor for maintained values:

Design Goals/Special Instructions:

FILE ATTACHMENTS:

FILE ATTACHMENTS:

Attach drawings, floor plans, etc., in the fields below.