I recently purchased an old home that was ~90% K&T. I've got nearly all of the old runs out and replaced with with romex or THHN in conduits. I'm getting a little hung up on the 1st floor fixtures though. The original plaster ceilings were redone with some 'ceiling tile'. They are not drop in tiles like a normal suspended ceiling. They're are snapped together (I'm assuming) and screwed/nailed to a furring strip that runs across the old plaster. Is it acceptable to run romex or even FMC between the plaster and the tiles? It sure would make life easier to not have to fool with the plaster. I may be missing it, but I haven't found anything that really applies in the 2011 NEC code book.
Short answer, no. The cabling must be protected, and just laying it up in a 1x cavity won't afford the protection required by code. You would have to remove the tile in order to install it anyway, so the tiles would self destruct, making a new ceiling mandatory. What is your ceiling height, now? I gather you don't have any access above this ceiling, since you mentioned "first floor".
If you are installing light fixtures, you will need to cut holes to accommodate the junction boxes, or the recessed fixtures. Your best bet is to run the cabling above the ceiling to each fixture. It may require the use of a 1/2" flexible 3 foot drill bit to go between the joists, but it is totally doable.
Yes, fish away. You'll only need protection if you have to drill through or notch a furring strip to cross over. A nail plate will be needed at each point where you do that.
Nothing wrong with "fishing" through the 3/4" gap afforded by the strapping, but what a PITA. As stated, you will have to core holes for the fixture boxes anyway, so fishing through the larger void between the floors will be much easier.
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