Ibew Local Union 292 Prevailing Wage Form Page 2
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2EMPLOYEE FULL NAME
LABOR CODE/AGREEMENT UNDER
___________________________________________ _____________________________________________________
___________________________________________ _____________________________________________________
___________________________________________ _____________________________________________________
___________________________________________ _____________________________________________________
___________________________________________ _____________________________________________________
___________________________________________ _____________________________________________________
___________________________________________ _____________________________________________________
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WORK ASSIGNED BY CONTRACTOR:
_____________________________________________
_____________________________________________
LABOR CODES:
_____________________________________________
407
ELECTRICIAN
_____________________________________________
430
WIRING SYSTEM TECH
431
WIRING SYSTEM INSTALLER
_____________________________________________
_____________________________________________
THIS PROJECT IS:
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Apartment Building * R
Motel/Hotel C
Residential * R
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Bicycle Path H
Nursing Facility*/Assisted Living R
Road/Street/Highway/Drive H
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Bridge Over Nav. Water H
Office/Commercial Building C
School C
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Bridge (Any Other Type) H
Paving H
Site Preparation C
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Dormitory R
Parking Lot H
Treatment Plant H
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Hospital C
Playground H
Water/Sewer H
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Other _________________________________________________________
*If you selected APARTMENT BUILDING, NURSING FACILITY or RESIDENTIAL:
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_______ # OF STORIES
KITCHEN IN EA. UNIT
IF YES
BATH IN EA. UNIT
IF YES
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FUNDING:
FEDERAL
STATE
PRIVATE
UNKNOWN
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OTHER CONTRACTORS ON THIS JOB: _________________________________________________
Non-Union
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_________________________________________________
Non-Union
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_________________________________________________
Non-Union
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_________________________________________________
Non-Union
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Parent category: Business