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I have a bathroom in which the light on the wall is offset from the center of the vanity by about 6 inches.

To avoid having to remove all of the wallpaper that is still in good shape, I bought a horizontal light fixture that is about 2-3 feet long with the intention of simply mounting it's center-point over by that distance to match the vanity and the remainder of the fixture will cover the existing junction box.

In addition to having the normal round junction box screws you'd expect on any light fixture mounted on a ceiling box, there are also "picture hanger" style slotted mounting points for a screw head to slide into farther down to the sides of this fixture.

The back of this fixture is a piece of sheet metal that detaches from the fixture to be mounted first. The design has the pattern for the JB in the middle. Can I simply find out my offset and then drill custom holes to match the original JB position while centering the fixture over the vanity?

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The NEC doesn't prohibit the modification, they just state that the instructions supplied by the manufacturer must be followed and the UL listing is based on that. There shouldn't be a problem mounting the fixture over the junction box and then punching a hole in the sheet metal backing and installing the appropriate connector and passing the wires from the fixture into the junction box.

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    The key point here being "installing the appropriate connector". Don't just stuff the wires though the ragged hole in the sheet metal!
    – brhans
    Oct 9, 2023 at 0:48
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    @brhans I could probably just use a breaker panel hole clamp and cut a 1/2 inch hole in the metal. Oct 9, 2023 at 2:15
  • I think a 1/2' hole would result in a concealed j-box, the punched hole would at least need to be large enough to access the box behind the fixture. Oct 9, 2023 at 2:37
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    @NoSparksPlease - most light fixtures cover the box. You access the box by unmounting the light fixture.
    – Jon Custer
    Oct 9, 2023 at 3:13
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    @RyanMortensen it depends on the existing cable. If the cable comes into the box from the left and you need to move it to the right, you're unlikely to have enough slack to simply move the box. Same probably holds if the cable comes in from top or bottom. If the cable comes in from the direction you want to move the box, should be no problem.
    – Huesmann
    Oct 10, 2023 at 12:44

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