Oregon 440 2570 Template

Oregon 440 2570 Template

The Oregon 440 2570 form serves as an Electrical License Application, providing a structured process for individuals aiming to acquire electrical licenses within the state. This form requires applicants to furnish detailed information regarding personal details, previous licenses, selected license types, and work experience, alongside a mandatory section for employment history verification. By meticulously completing and submitting this form, alongside the necessary payment to the Department of Consumer & Business Services, applicants advance towards obtaining the requisite credentialing to legally engage in electrical work in Oregon.

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In the state of Oregon, professionals seeking to work in the electrical field must navigate through various administrative steps, one of which includes the completion and submission of the Oregon 440 2570 form, an Electrical License Application. This document is crucial as it serves as a gateway for obtaining the necessary credentials from the Department of Consumer & Business Services, Building Codes Division. The form encapsulates several pivotal sections designed to assess an applicant's eligibility for licensure, ranging from personal information, previous licenses, and the specific license type being applied for, to detailed employment history and verification of work experience. Additionally, applicants are required to submit a photograph for identification purposes and sign an affidavit affirming the accuracy of the information provided. Given the non-refundable nature of the application fees and the severity of penalties for falsification, the form emphasizes the importance of thoroughness and honesty in the application process. Moreover, the extensive checklist and variety of supporting documents requested, including proof of experiential learning and formal education, reflect the comprehensive evaluation undertaken to ensure that only qualified individuals are authorized to perform electrical work within Oregon. This multifaceted approach underlines the state’s commitment to safety, competence, and professional integrity in the electrical industry.

Preview - Oregon 440 2570 Form

Electrical License Application

Mail application with payment to:

 

DCBS Fiscal Services

Department of Consumer & Business Services

P.O. Box 14610

Building Codes Division 1535 Edgewater St. NW, Salem, Oregon

Salem, OR 97309-0445

Phone: (503) 373-1268 • Fax: (503) 378-2322

 

Web: bcd.oregon.gov

 

Important: Read the application instructions before completing this form. Please complete all steps before submitting your application and refer to the checklist at the end of this form.

STEP 1

 

 

APPLICANT INFORMATION (please print)

Last

 

 

 

 

First

 

Middle initial

Name:

 

 

 

 

 

 

 

Address (street or P.O. Box):


 
 
 
 


 

 

 

 

City:

 

 

 

 

State:

 

ZIP:

 

 

 

 

 

 

 

 

Phone: (

)

 

Fax: (

)

 

E-mail:

 

 

 

 

 

Social Security number (Required, ORS 25.785):

 

Your Social Security number is required for BCD licenses, certifications, and registrations according to ORS 25.785, ORS 305.385, 42 USC § 405 (c)(2)(C)(i), and 42 USC § 666(a)(13). Failure to provide this information will be basis for application refusal. Your SSN may be shared with other authorities only for tax-administration purposes and child-support enforcement (including identification).

STEP 2

PREVIOUS LICENSES

List all individual or contractor electrical licenses you hold or have held in any state. Submit a copy of all out-of-state licenses with your application.

List license(s):

STEP 3

LICENSE TYPE

 

 

Please select a license type from the list below. Fees are nonrefundable.

The application instructions list the requirements and scope of each license.

General supervising electrician (S) $100.00 General journeyman (J) $100.00

Limited supervising electrician (PS) $100.00

Limited journeyman manufacturing plant (PJ) $100.00 Limited energy technician Class A (LEA) $50.00 Limited energy technician Class B (LEB) $50.00

Limited maintenance electrician (LME) $100.00 Limited residential electrician (LR) $100.00 Limited journeyman sign electrician (SIG) $50.00 Limited journeyman stage electrician (ST) $50.00 Limited building maintenance electrician (BME) $50.00 Limited renewable energy technician (LRT) $50.00 Ltd. maintenance manufactured structures (LMM) $100.00

STEP 4

TEST LOCATION

 

 

Please refer to the enclosed list or our Web site to choose a test location.

Reciprocal applicants do not test.

Preferred testing location:

Make check or money order payable to Department of

Consumer & Business Services. If paying by credit card, applicant must sign credit card information box. DO NOT SEND CASH.

Visa

MasterCard

Discover

Phone: (

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

/

 

 

 

 

 

 

 

 

Credit card number

 

 

 

 

Expiration date

 

 

 

 

 

 

Name of cardholder as shown on credit card

 

 

 

 

 

 

 

 

$

 

 

Cardholder signature

 

 

 

 

Amount

 

 

 

 

 

 

 

 

Secure fax for

credit card payments:

(503) 947-2333

Fee varies based on license type.

DCBS Fiscal use only: 12104/0600

Page 1 440-2570 (1/08/COM)

STEP 5

EMPLOYMENT HISTORY

List your experience in order, beginning with your present or most recent position. If more space is needed, attach additional sheets.

Please print

Employer’s name:

 

 

 

Period of employment:

 

 

 

 

Address:

 

 

 

 

From:

To:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hours worked per week:


 
 



 
 


 

 

 

 

 

 

 

 

 

 

 

 

Phone:

(

)

 

Position/title:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Supervisor’s name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Describe work performed:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer’s name:

 

 

 

 

Period of employment:

 

 

 

 

Address:

 

 

 

 

 

From:

To:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hours worked per week:


 
 



 
 


 

 

 

 

 

 

 

 

 

 

 

 

 

Phone:

(

)

 

 

Position/title:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Supervisor’s name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Describe work performed:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer’s name:

 

 

 

Period of employment:

 

 

 

 

Address:

 

 

 

 

From:

To:

 

 

 

 

 

 

 

 

 

 

 

 

 

Hours worked per week:


 
 



 
 


 

 

 

 

 

 

 

 

 

 

 

 

Phone:

(

)

 

Position/title:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Supervisor’s name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Describe work performed:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer’s name:

 

 

 

 

Period of employment:

 

 

 

 

Address:

 

 

 

 

 

From:

To:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hours worked per week:


 
 



 
 


 

 

 

 

 

 

 

 

 

 

 

 

 

Phone:

(

)

 

 

Position/title:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Supervisor’s name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Describe work performed:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Applicant name:

440-2570 (1/08/COM)

Page 2

Electrical License Application

STEP 6

VERIFICATION OF WORK EXPERIENCE

To provide proof of your work experience, submit an Electrical Experience Verification form (440-2570A) from each of your employers.

OR

Applicants relying on military experience must submit the following:

•
 Official documentation from supervising official showing the type and approximate hours of work experience

•
 Other reliable documentation verifying training and experience if supervisor not located

STEP 7

PHOTOGRAPH OF APPLICANT

Applicants must submit a 2” x 2” passport-style photo. Write your name on the back of your photo and submit it with your application. This photo will be printed on your license when it is issued. Please do not staple the photo.

STEP 8

APPLICANT AFFIDAVIT

1.I hereby certify that, to the best of my knowledge, the information on this application is complete and correct.

2.I understand that my license may be suspended, conditioned, or revoked if I have deliberately falsified my application. ORS 455.125

3.I understand that, if I provide false information on this application or cheat on a licensing examination, my application will be denied and I may not apply for any license or be allowed to take any division-related examination for one year from the date of denial. OAR 918-001-0040

4.I certify that I have read these statements and understand the terms of my license.

Name (print):

Applicant signature:

 

Date:

 

 

 

 

 

 

 

 

 

STEP 9

CHECKLIST FOR APPLICANTS

1.

2.

3.

4.

5.

6.

7.

Application form completed (Form 440-2570) Affidavit signed and dated (Step 8 on application)

Verification of work experience (Form 440-2570A) from each employer. Additional documentation:

Proof of completion of an Oregon-approved apprenticeship or training program

Proof of completion of an out-of-state apprenticeship program recognized by the state of Oregon Official transcripts of classroom training

Proof of a high school diploma, GED, or equivalent. A college degree will substitute. Passport-style photo (2” x 2”) with applicant’s name on the back

Payment of fee

 

 

 

 

DEPARTMENT USE ONLY

 

Approved

Signature:

 

Date:

 

 

 

 

 

 

 

 

 

Denied

Signature:

 

Date:

Comments:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Apprentice applicants must provide proof of completion of a recognized apprenticeship program.

Applicant name:

440-2570 (1/08/COM)

Page 3

Electrical License Application

Electrical Experience Verification

Mail verification to:

Building Codes Division

Department of Consumer & Business Services

P.O. Box 14470

Building Codes Division 1535 Edgewater St. NW, Salem, Oregon

Salem, OR 97309-0404

Phone: (503) 373-1268 • Fax: (503) 378-2322 • TTY: (503) 373-1358

 

Web: bcd.oregon.gov

 

Instructions: You must submit a separate experience verification form for each place of employment. If you are submitting more than one form, do not overlap dates of employment.

 

STEP 1

 

 

 

 

 

 

APPLICANT INFORMATION (please print)

 

 

 

 

 

 

 

Name (applicant):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City:

 

 

 

 

 

 

 

 

 

State:

 

ZIP:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone:

(

)

 

Fax: (

)

 

 

 

E-mail:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STEP 2

 

 

 

 

 

 

 

 

PERIOD OF EMPLOYMENT

 

 

 

 

 

 

 

Employer’s name:

 

 

 

 

 

Period of employment:

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

From:

To:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hours worked per week:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone:

(

)

 

 

 

 

 

 

Applicant’s position/title:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STEP 3

 

 

 

 

 

 

 

 

VERIFIER INFORMATION

 

 

 

 

 

 

Applicants submitting verification of equivalent training and experience under OAR 918-030-0030(1)(c) must provide verification from the following persons:

A current or previous employer actively involved with the applicant’s work;

The individual who supervised the work if the current or previous employer is no longer in business, is deceased, or otherwise cannot be located; or

A co-worker who was directly involved in the work performed, only if both the employer and the supervisor cannot be located. Co-worker verification must be accompanied by supporting documentation, such as employment records, showing that the verifier worked with the applicant and has knowledge of the work performed.

Name of verifier:

Address:

 

 

Phone: (

)

 

 

 

 

 

 

 

 

 

City:

State:

 

ZIP:

 

 

 

 

 

 

 

 

 

License number(s):

 

 

 

 

 

 

 

 

 

 

 

 

Verifier’s employment relationship to applicant:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

440-2570A (7/06/COM/WEB)

Page 1

Applicant (print name):

STEP 4

VERIFIED EXPERIENCE

1.Enter the type of license you are applying for:

2.From license types on Page 3, choose the categories in which you have work experience and enter them under “Category.” (See example, below.)

3.Under “Total hours,” enter the hours of work experience in each category. The division will consider no more than 2,000 hours of experience per year. OAR 918-282-0030(4).

4.Enter your specific work duty experience under “Description of duties.” If you need more information, see bcd.oregon.gov, “Statutes and Rules,” “Oregon Administrative Rules,” click on 918-282, then scroll down to the desired license type.

5.Make copies of this page, if needed.

Category

 

Total hours

 

Description of duties

(example) Residential wiring

2000

 

Installations, wire pulling, service and panel, conduit, flex, metal

 

 

 

 

 

 

 

 

 

romex boxes, electrical heating systems

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STEP 5

VERIFIER CONFIRMATION

As the verifier of the preceding information, I confirm that it is true and correct to the best of my knowledge.

Verifier name (please print):

Verifier signature:

 

Date:

 

 

 

440-2570A (7/06/COM/WEB)

Page 2

Electrical Experience Verification

ELECTRICAL WORK EXPERIENCE CATEGORIES

General journeyman (J)

General supervisor (S)

Limited residential (LR)

Stockroom, materials handling

Residential wiring

Commercial installations

Industrial installations

Troubleshooting and maintenance

Finishing and fixture hanging

Signal and control systems

Remodeling

Underground construction

Limited supervisor (PS)

Limited plant journeyman (PJ)

Limited maintenance electrician (LME)

Electrical circuits

Motors and generators

Controls, manual and automatic

Troubleshooting

In-place motor cleaning

Lighting

Electrical drawings

Limited journeyman sign (SIG)

Stockroom, materials handling

Pattern and blueprints

Layout design

Assembly of display

Display painting and component parts

Display installation, service, and maintenance

Transportation and hoisting equipment maintenance and repair

Limited journeyman stage (ST)

Stage/film and video/event lighting

Stage/film and video dimmer distribution

Three-phase temporary power distribution

Stage/film and video lamp operator

Stage/film and video/event property

Limited energy, Class A (LEA)

Limited energy, Class B (LEB)

Protective signaling (fire alarm, nurse call, burglar alarm, security and voice evacuation systems that are part of a fire or life safety system) (LEA only)

HVAC

Medical

Boiler controls

Intercom, paging, sound, CCTV

Clock systems

Data telecommunications

Instrumentation

Security

Stockroom, materials handling, shop and service

Limited energy wiring: installations, wire pulling, splices, conduit, flex, tray and duct, control panels and controls, wiring devices, removal and finish work

Troubleshooting and maintenance

Outdoor installations, overhead and underground

Occupation or trade-specific training related to license

Limited building maintenance (BME)

Electrical appliances

Light switches

Light fixtures

Fans

Receptacles

Fluorescent ballasts

Limited renewable energy technician (LRT)

Available only by completing an Oregon apprenticeship

Limited maintenance manufactured structures (LMM)

Two years of experience as a trainee in the repair and maintenance of electrical problems found in manufactured structures, while employed by a manufactured structures manufacturer

To see a detailed list of minimum hourly requirements for each category, go to our Web site, bcd.oregon.gov, “Statutes and Rules,” “Oregon Administrative Rules,” click on 918-282, then scroll down to the desired license type.

440-2570A (7/06/COM/WEB)

Page 3

Electrical Experience Verification

Electrical License Application Instructions

Department of Consumer & Business Services

Building Codes Division 1535 Edgewater St. NW, Salem, Oregon P.O. Box 14470, Salem, OR 97309-0404

Phone: 503-373-1268 • Fax: 503-378-2322

Web: bcd.oregon.gov

Mail application, required documents, your photo, and payment to:

DCBS Fiscal Services

P.O. Box 14610

Salem, OR 97309-0445

LICENSING PROCESS

1.Review the licensing information on Pages 2-4 to determine the scope of work allowed under each license and whether you meet the qualifications for the license.

2.Complete the electrical license application (Form 440-2570) and send all required documentation, your photograph, and fees to the Department of Consumer and Business Services (DCBS). Use the checklist below to ensure your application is complete. Incomplete applications may delay evaluation of your applications.

3.Building Codes Division sends approved applicants a letter of authorization to take an examination. The letter explains the examination procedures and provides the address and telephone number of the test site. The applicant is responsible for scheduling the examination with the test site office.

4.If your application is denied, Building Codes Division will send a denial letter explaining your rights to a hearing.

5.Allow two weeks for Building Codes Division to grade your exam. If you pass the examination, Building Codes Division will issue your license and mail a photo identification card to you.

6.During each three-year license period, all licensees are required to complete continuing education. Go to bcd.oregon.gov to see the continuing education requirements for each license type.

ELECTRICAL LICENSE EXPERIENCE VERIFICATION INSTRUCTIONS

Most applicants are required to submit verification of electrical experience (Form 440-2570A), signed by a verifier, for each place of employment.

1.The person verifying the applicant’s work must be a current or previous employer. If an employer is not available, the person who supervised the work may verify experience. If neither an employer nor supervisor is available, a co-worker who was directly involved may verify experience.

2.The verifier must identify specific categories (e.g., “finishing and fixture hanging,” “commercial installations,” “troubleshooting and maintenance”) from Page 3 of the verification form and list the number of hours worked in each category on the form. A description of duties for each category must be included.

3.The verifier must sign and date the form.

CHECKLIST FOR ELECTRICAL LICENSE APPLICATION

1. Application form completed (Form 440-2570).

2. Affidavit signed and dated (Step 8 on application).

3. Verification of work experience (Form 440-2570A) from each employer.

4. Any additional required documents:

Proof of completion of an Oregon-approved apprenticeship or training program.

Proof of completion of an out-of-state apprenticeship program recognized by the state of Oregon.

Official transcripts of classroom training.

5. Proof of high school diploma, GED, or equivalent. A college degree will substitute.

6. Passport-style photo (2" x 2") with applicant’s name on the back.

7. Payment of fee.

Page 1 440-2570-I (3/08/COM)

ELECTRICAL LICENSE REQUIREMENTS AND SCOPE OF WORK

Applicants are required to provide proof of training and work experience equivalent to an Oregon apprenticeship program. If applicants do not have related training classes, they may alternatively submit verification of twice the amount of required work experience. OAR 918-030-0030(2)

“300 percent rule”: For some licenses, no more than three times the number of minimum hours (300 percent) will be allowed for a single category of work experience. Categories of work experience (residential, commercial, industrial, etc.) required for each license type are listed on the Electrical Experience Verification (Form 440-2570A). Example of

“300 percent rule”: If the minimum requirement is 1,000 hours of residential work, the maximum credit allowed in the residential category is 3,000 hours — three times 1,000.

Below is a brief summary of the work a license holder is allowed to perform and the requirements for each license.

License type and

What this license

The requirements

rule reference

authorizes you to do

for this license

 

 

(1) Be currently licensed as an Oregon journeyman

 

Design, plan, and lay out work; sign all

electrician AND provide verification of an additional

General supervising

8,000 hours of on-the-job journeyman experience.

permits; licensee is the only individual

electrician

OR

authorized to direct, supervise, or control

(S)

(2) Meet the qualifications to be licensed as an Oregon

 

the installation or alteration of an

journeyman electrician and provide verification of an

OAR 918-282-0140

electrical service.

 

 

additional 8,000 hours of on-the-job journeyman

 

 

 

 

experience. (300 percent rule applies.)

 

 

 

 

 

(1) Be currently licensed as an Oregon limited journeyman

 

Design, plan, and lay out work; sign all

manufacturing plant electrician AND provide verification

 

permits; licensee is the only individual

of an additional 8,000 hours of on-the-job plant

Limited supervising

authorized to direct, supervise, or control

journeyman experience.

electrician

the installation, maintenance,

OR

(PS)

replacement, and repair of electrical

(2) Meet the qualifications to be licensed as a limited

OAR 918-282-0160

wiring and electrical products on or in an

journeyman manufacturing plant electrician AND provide

 

 

 

existing operable plant, hospital,

verification of an additional 8,000 hours of on-the-job

 

commercial building, or institution.

plant journeyman experience obtained outside of

 

 

Oregon. (300 percent rule applies.)

 

 

 

 

 

(1) Completion of an approved apprenticeship program

 

 

in Oregon.

 

 

OR

 

 

(2) Official transcripts verifying 576 hours of classroom

 

Make any electrical installation under

training AND verification of 8,000 hours of on-the-job

General journeyman

the supervision, direction, and control of

experience obtained outside of Oregon. Experience MUST

electrician

a general supervising electrician, unless

include a breakdown of hours, showing a minimum of

(J)

doing work that requires the direction of

1,000 hours in EACH category: residential, commercial,

OAR 918-282-0170

a limited supervising electrician or doing

and industrial. (300 percent rule applies.)

 

OR

 

work requiring no supervision.

 

 

(3) Verification of 16,000 hours of on-the-job experience

 

 

obtained outside of Oregon showing a minimum of

 

 

2,000 hours in EACH category: residential, commercial,

 

 

and industrial. (300 percent rule applies.)

 

 

 

Reciprocal general

Design, plan, and lay out work; sign all

(1) Possess an active supervisor/master license in a state

permits; licensee is the only individual

that has a reciprocal licensing agreement with Oregon.

supervising electrician

authorized to direct, supervise, or control

Please refer to our Web site: bcd.oregon.gov/licensing for

(S)

the installation or alteration of an

reciprocal agreements and the application form, Reciprocal

OAR 918-030-0045

electrical service.

Electrical and Plumbing License Application.

 

 

 

 

 

Make any electrical installation under

(1) Possess an active general journeyman license in a state

Reciprocal journeyman

the supervision, direction, and control of

that has a reciprocal licensing agreement with Oregon.

electrician

a general supervising electrician, unless

Please refer to our Web site: bcd.oregon.gov/licensing for

(S)

doing work that requires the direction of

reciprocal agreements and the application form, Reciprocal

OAR 918-030-0045

a limited supervising electrician or doing

 

work requiring no supervision.

Electrical and Plumbing License Application.

 

 

 

 

 

440-2570-I (3/08/COM)

Page 2

Electrical License Application Instructions

License type and rule

What this license

 

The requirements

reference

authorizes you to do

 

for this license

 

 

(1) Completion of an approved apprenticeship program

 

 

 

in Oregon.

 

Make electrical installations on one- and

 

OR

Limited residential

(2)

Official transcripts verifying 288 hours of classroom

two-family or multifamily dwelling

 

training AND verification of 4,000 hours of on-the-job

electrician

units, not exceeding three floors above

 

 

residential experience obtained outside of Oregon.

(LR)

grade. (Must work under the

 

 

(300 percent rule applies.)

 

supervision, direction, and control of a

 

OAR 918-282-0180

 

OR

general supervising electrician.)

 

 

(3)

Verification of 8,000 hours of on-the-job residential

 

 

 

 

 

experience obtained outside of Oregon. (300 percent

 

 

 

rule applies.)

 

 

 

 

Install, maintain, replace, and repair

(1) Completion of an approved apprenticeship program

 

 

in Oregon.

 

electrical wiring and electrical products

 

 

 

OR

 

on or in an existing operable

 

Limited journeyman

(2)

Official transcripts verifying 576 hours of classroom

manufacturing plant or industrial plant

manufacturing plant

 

training AND verification of 8,000 hours of on-the-job

owned or used by employer. (Must work

 

electrician

 

commercial and industrial experience obtained outside

under the supervision, direction, and

 

(PJ)

 

of Oregon. (300 percent rule applies.)

control of a limited supervising

 

 

 

OR

OAR 918-282-0190

electrician. If there is no supervising

 

 

Verification of 16,000 hours of on-the-job commercial

 

(3)

 

electrician, licensee is limited to repair

 

 

and industrial experience obtained outside of Oregon.

 

and maintenance work.)

 

 

 

(300 percent rule applies.)

 

 

 

 

 

 

 

Limited renewable

Make renewable energy system

 

 

energy technician

installations. (Must be employed by a

(1)

Completion of an approved apprenticeship program

(LRT)

limited renewable energy contractor or

 

in Oregon.

OAR 918-282-0205

electrical contractor.)

 

 

 

 

 

 

 

 

 

 

(1) Completion of an approved apprenticeship program

 

 

 

in Oregon.

 

 

 

OR

Limited journeyman sign

Install and service electrical signs and

(2)

Official transcripts of required classroom training AND

electrician

 

verification of 4,000 hours of on-the-job sign

outline lighting. (Must be employed by a

 

(SIG)

 

electrical experience obtained outside of Oregon.

limited sign contractor.)

 

 

 

OR

OAR 918-282-0220

 

 

 

 

 

 

 

(3) Verification of 8,000 hours of on-the-job sign

 

 

 

experience obtained outside of Oregon, broken down

 

 

 

into specific work categories.

 

 

 

 

 

Install temporary feeders, branch circuits,

(1)

Official transcripts verifying 150 hours of required

Limited journeyman

and equipment used for the production of

 

classroom training AND verification of 4,000 hours of

shows, exhibits, displays, festivals,

 

on-the-job experience obtained outside of Oregon.

stage electrician

 

conventions, stage, theater, film, or video

 

OR

(ST)

 

productions; perform maintenance on

(2)

Verification of 8,000 hours of on-the-job stage

OAR 918-282-0230

temporary equipment. (Must be employed

 

experience obtained outside of Oregon, broken down

 

 

 

by an electrical contractor.)

 

into specific work categories.

 

 

 

 

 

(1) Completion of an approved apprenticeship in Oregon.

 

 

 

OR

 

Repair and maintain existing electrical

(2)

Official transcripts verifying 288 hours of required

Limited maintenance

installations on or in an existing

 

classroom training AND verification of 4,000 hours of

electrician

operable plant, commercial building, or

 

on-the-job training or experience obtained outside of

(LME)

institution. (An LME is not authorized to

 

Oregon. (300 percent rule applies.)

OAR 918-282-0240

make new electrical installations or to

 

OR

 

 

 

 

perform work on services.)

(3)

Verification of 8,000 hours of on-the-job experience

 

 

 

obtained outside of Oregon, broken down into specific

 

 

 

work categories. (300 percent rule applies.)

 

 

 

 

440-2570-I (3/08/COM)

Page 3

Electrical License Application Instructions

License type and rule

What this license

 

The requirements

reference

authorizes you to do

 

for this license

 

Maintain, repair, and replace electrical

(1)

Completion of an approved one-year training program

 

appliances, light switches and fixtures,

 

 

in Oregon.

 

fans, receptacles, and fluorescent

 

Limited building

 

OR

ballasts on the premises of commercial

 

maintenance electrician

(2)

Verification of 2,000 hours of on-the-job training or

office buildings, buildings occupied by

(BME)

 

experience in maintenance, repair, and replacement of

the state or a local government entity,

 

OAR 918-282-0260

 

electrical appliances, light switches, light fixtures,

and facilities designated by the Electrical

 

 

 

fans, receptacles, and fluorescent ballasts. (300

 

and Elevator Board in electrical systems

 

 

 

percent rule applies.)

 

not exceeding 300 volts to ground.

 

 

 

 

 

 

 

 

 

(1) Completion of an approved apprenticeship in Oregon.

 

 

 

OR

 

 

(2) Official transcripts verifying 432 hours of required

 

 

 

classroom training, AND verification of 6,000 hours of

Limited energy

Install, alter, and repair all limited

 

on-the-job training broken down into specific work

technician,

energy systems. (An LEA must be

 

categories. (300 percent rule applies.)

Class A

licensed as an electrical contractor or

 

OR

(LEA)

must work for an electrical contractor,

(3)

Verification of 12,000 hours of work experience

limited energy contractor, or for one

 

obtained outside of Oregon, broken down into specific

OAR 918-282-0345

 

 

 

 

OAR 918-282-0355

employer in an industrial plant.)

 

work categories. Requires trade-specific installation

 

 

 

experience in protective signaling that includes fire

 

 

 

alarm, nurse call, burglar alarm, and other systems

 

 

 

that are part of a fire or life safety system. (300

 

 

 

percent rule applies.)

 

 

 

 

 

(1) Completion of an approved apprenticeship in Oregon.

 

 

 

OR

 

 

(2) Official transcripts verifying 288 hours of required

 

 

 

classroom training AND

 

Perform limited energy electrical

 

(a) Verification of 4,000 hours of work experience

Limited energy

 

broken down into specific work categories (300

activity that does not include protective

 

technician,

 

percent rule applies) AND

signaling. (An LEB must be licensed as

 

Class B

 

(b) Completion of a board-approved 32-hour training

an electrical contractor, or must work for

 

(LEB)

 

program (may be taken after application is

an electrical contractor, limited energy

 

 

approved).

 

 

OAR 918-282-0360

contractor, or for one employer in an

 

 

 

OAR 918-282-0365

 

OR

industrial plant.)

 

 

 

 

(3)

Verification of 8,000 hours of work experience

 

 

 

 

 

obtained outside of Oregon, broken down into specific

 

 

 

work categories (300 percent rule applies), AND

 

 

 

completion of a board-approved 32-hour training

 

 

 

program (may be taken after application is approved).

 

 

 

 

 

(1) Two years of experience, consisting of at least 4,000

 

 

 

hours, in repair and maintenance of electrical

 

 

 

problems in manufactured structures while employed

Limited maintenance

 

 

by a manufactured structures manufacturer.

 

 

OR

manufactured structures

Repair or maintain electrical wiring and

 

(2)

Two years of employment as a limited-maintenance

(LMM)

equipment in manufactured structures.

 

manufactured-structures trainee working with a

OAR 918-282-0250

 

 

 

 

licensee or for an employer of a licensee.

 

 

 

 

 

 

OR

 

 

(3) A combination of (1) and (2) above equaling two

 

 

 

years of experience.

 

 

 

 

440-2570-I (3/08/COM)

Page 4

Electrical License Application Instructions

File Features

Fact Detail
Form Number 440-2570
Form Title Electrical License Application
Submission Address Department of Consumer & Business Services P.O. Box 14610, Salem, Oregon 97309-0445
Department Building Codes Division
Contact Information Phone: (503) 373-1268, Fax: (503) 378-2322
Website bcd.oregon.gov
Governing Laws ORS 25.785, ORS 305.385, 42 USC § 405 (c)(2)(C)(i), and 42 USC § 666(a)(13)
License Types Offered Includes General supervising electrician, General journeyman, Limited energy technician among others.
Fee Payment Method Check, Money Order, Visa, MasterCard, Discover
Photo Requirement 2” x 2” passport-style photo
Verification of Work Experience Submission of Electrical Experience Verification form (440-2570A) is required for each employer.

Detailed Steps for Using Oregon 440 2570

Filling out the Oregon 440-2570 form is an essential step towards obtaining various types of electrical licenses within the state. This process involves a series of clearly articulated steps aimed at ensuring that all prospective candidates meet the necessary criteria for their desired electrical license. Accuracy and attention to detail are key, as the information provided will be rigorously reviewed for compliance with state regulations. Following the outlined steps carefully will make the application process smoother and more efficient.

  1. Applicant Information: Clearly print your legal name (last, first, middle initial), address (street or P.O. Box), city, state, ZIP code, phone and fax numbers, and email address. Include your Social Security number as required by law.
  2. Previous Licenses: List all individual or contractor electrical licenses you currently hold or have previously held in any state. Attach copies of all out-of-state licenses with your application.
  3. License Type: Select the desired license type from the options provided and take note of the nonrefundable fee associated with each type. Refer to the application instructions for specifics on requirements and the scope of each license.
  4. Test Location: Choose your preferred testing location from the provided list or the website. Reciprocal applicants are exempt from testing. Fill in your credit card information if you opt to pay the fee by Visa, MasterCard, or Discover.
  5. Employment History: Starting with your current or most recent job, list your employers, the period of employment, addresses, hours worked per week, phone numbers, positions/titles, supervisors' names, and a brief description of the work performed. Attach additional sheets if more space is needed.
  6. Verification of Work Experience: Submit an Electrical Experience Verification form (440-2570A) from each employer listed. Military applicants must provide official documentation and other reliable verification of their training and experience.
  7. Photograph of Applicant: Include a 2” x 2” passport-style photo with your name written on the back. Do not staple the photo to the application.
  8. Applicant Affidavit: Read the statements in Step 8 thoroughly, print your name, sign, and date the affidavit to affirm that your application is complete and accurate.
  9. Checklist for Applicants: Before submitting your application, ensure all required documents and fees are included, such as the completed 440-2570 form, signed affidavit, verification of work experience, any additional supporting documentation, and your passport-style photo.

It's important to review your application and the accompanying documents for completeness and accuracy before mailing everything to the address provided. This careful preparation helps avoid unnecessary delays, ensuring your application proceeds through the review process smoothly. Remember to keep a copy of the entire application packet for your records.

Important Points on This Form

What is the purpose of the Oregon 440 2570 form?

The Oregon 440 2570 form is designed for individuals applying for various types of electrical licenses in Oregon. It serves as the primary application to collect applicant information, verify work experience, and determine eligibility for the desired licensure. This includes general supervising electrician, journeyman, limited residential electrician, and several other specialized electrical positions. Completing this form is the first step in obtaining a license to practice in the electrical field within the state.

What are the steps to complete the Oregon 440 2570 application?

Completing the Oregon 440 2570 application involves several key steps:

  1. Filling out applicant information, including contact details and Social Security number.
  2. Listing previous licenses, if any, including providing copies of out-of-state licenses.
  3. Selecting the type of license you are applying for and noting the associated fee.
  4. Choosing a test location, if required.
  5. Providing a detailed employment history.
  6. Submitting verification of work experience using the Electrical Experience Verification form.
  7. Attaching a 2"x2" passport-style photograph of the applicant.
  8. Signing the applicant affidavit confirming the accuracy of the information provided.

Applicants should also review the checklist at the end of the application to ensure all necessary documents and fees are included before submission.

How can work experience be verified for the application?

Work experience can be verified by submitting an Electrical Experience Verification form (440-2570A) from each employer listed in the employment history section of the application. For individuals relying on military experience, official documentation showing the type and approximate hours of work experience is required. Additionally, other reliable documentation verifying training and experience must be submitted if the supervising official is not located.

Is there a fee associated with the Oregon 440 2570 application?

Yes, the Oregon 440 2570 application requires a fee, which varies based on the license type you are applying for. Fees are clearly listed in the application form next to each license type. It's important to note that these fees are nonrefundable. Applicants can make payments through check, money order, or credit card but should refrain from sending cash.

What documentation is needed in addition to the 440 2570 form?

In addition to the 440 2570 form, applicants must provide:

  • Verification of work experience through the 440-2570A form from each employer.
  • Additional documentation such as proof of completion of an Oregon-approved apprenticeship or training program, official transcripts of classroom training, or a high school diploma, GED, or equivalent. A college degree may substitute for some of these requirements.
  • A 2"x2" passport-style photo with the applicant's name on the back.

Ensuring that all necessary documentation is included with the application is crucial for a smooth review process.

Who should be contacted for more information or if there are questions about the application?

For more information or if there are questions about the application process, applicants are encouraged to contact the Department of Consumer & Business Services, Building Codes Division. They can be reached by phone at (503) 373-1268, by fax at (503) 378-2322, or through their website. The department's staff can provide guidance and support throughout the application process.

Common mistakes

Filling out the Oregon 440 2570 form for an electrical license application can be quite the task. Here are nine common mistakes people make during the process that could potentially set back their application:

  1. Not reading the application instructions carefully before starting – This form comes with a detailed instruction sheet for a reason. It helps ensure you fill out each section correctly.
  2. Leaving sections blank – Every section of the Oregon 440 2570 form is there to collect necessary information. If a section does not apply to you, it's better to fill it with "N/A" than to leave it empty.
  3. Failing to list all previous licenses – The form asks for all individual or contractor electrical licenses you hold or have held. Forgetting to list any could cause processing delays.
  4. Forgetting to submit copies of out-of-state licenses – If you have electrical licenses from other states, copies must accompany your application, as stated in the instructions.
  5. Omitting the Social Security number – Your Social Security number is required for background checks and for other official purposes. Not including it will result in application refusal.
  6. Incorrectly selecting the license type – Make sure the license type selected aligns with your qualifications and the kind of work you plan to do. This mistake can cost you both time and the application fee.
  7. Not attaching additional sheets for employment history – If your employment history doesn't fit in the provided space, it's essential to attach additional sheets detailing your work experience. Overlooking this step can leave your application incomplete.
  8. Forgetting the passport-style photo – A 2" x 2" photo is a must and should be submitted with your application un-stapled. It's an easy step to miss but crucial for completing your application packet.
  9. Sending cash instead of a check, money order, or card payment – For security reasons, sending cash through the mail is discouraged. Your application fee should be paid via check, money order, or credit card only.

Mistakes can happen to anyone, but ensuring your application is accurate and complete the first time around can save a significant amount of time and hassle. Double-check each section, follow the accompanying instructions carefully, and reach out for help if needed. A little extra attention to detail can make all the difference in smoothly securing your electrical license in Oregon.

Documents used along the form

When applying for an electrical license in Oregon, using the 440-2570 form is just the starting point. Alongside this primary application, several other forms and documents play a crucial role in the application process. These additional forms and documents ensure that all facets of an applicant’s qualifications and experiences are thoroughly documented and verified.

  • Electrical Experience Verification Form (440-2570A): This is a critical document for verifying an applicant's work experience in the electrical field. Applicants must submit a separate form for each employer to demonstrate their experience, with detailed information about their employment period, hours worked, and specific duties performed.
  • Official Documentation for Military Experience: For applicants relying on military experience, official documentation from a supervising official is required. This includes details about the type and hours of work experience, along with any other documentation that verifies training and experience if the supervisor cannot be located.
  • Proof of Completion of Apprenticeship Program: Applicants who have completed an Oregon-approved apprenticeship or an out-of-state apprenticeship program recognized by Oregon must provide proof of completion. This assures the board of the applicant’s formal training in the field.
  • Official Transcripts of Classroom Training: To further validate an applicant’s educational background in electrical work, official transcripts that show completed coursework relevant to the electrical field are necessary. This may include programs taken as part of an apprenticeship or separate courses aimed at enhancing electrical knowledge and skills.
  • Proof of High School Diploma, GED, or Equivalent: A fundamental requirement is the submission of a high school diploma, General Education Development (GED) certificate, or equivalent. In some cases, a college degree may serve as a substitute, verifying the applicant’s basic educational foundation.

Collectively, these documents complement the Oregon 440-2570 form, painting a full picture of an applicant's readiness and qualification for an electrical license. The meticulous documentation ensures that only qualified individuals are entrusted with the responsibilities that come with being a licensed electrician in Oregon. It’s a process designed to uphold the highest standards of safety and excellence in the electrical trade.

Similar forms

The Oregon 440 2570 form is an electrical license application used to process applicants seeking certification in various electrical fields within the state. This form is comparable to similar licensing forms in other professions, emphasizing the structured and regulated process of entering specialized professions. For instance, the California Registered Nurse (RN) License Application shares similarities as it also requires personal information, detailed employment history, verification of educational qualifications, and an affirmation of the truthfulness of the provided information. Both forms serve as a gateway to professional practice, ensuring that candidates meet specific criteria and standards before being allowed to work in their respective fields.

Another document with similarities is the Contractor License Application found in many states, such as the New York State Contractor Application. Like the Oregon electrical license application, it demands extensive information about the applicant's business history, specialty, previous licenses, and proof of financial stability. Both documents aim to vet individuals or businesses for the competency and integrity necessary to protect the public and ensure quality workmanship in their trades.

The Uniform Application for Physician State Licensure (UAPSL) serves a parallel purpose in the medical field. It collects detailed personal, educational, and professional experience, similar to the Oregon 440 2570 form. Both applications require verification of qualifications and previous licensure, aiming to uphold high standards within their respective professional communities and ensure public safety.

Furthermore, the Real Estate License Application found in states like Texas mirrors the structured approach to licensing seen in the Oregon electrical license application. Applicants must disclose previous licenses, provide a history of employment, and demonstrate their qualifications. Both processes include steps to ensure that only qualified and reliable professionals gain and maintain permission to practice, enhancing trust in these sectors.

The Professional Engineer License Application, such as those used by the Florida Board of Professional Engineers, also shares commonalities with the Oregon 440 2570 form. Applicants must supply detailed education and work experience, pass examinations, and agree to ethical standards. These procedures highlight the rigorous standards and accountability expected in professions with significant public impact.

A Commercial Driver's License (CDL) Application is another document with functional similarities. While focused on the transportation industry, it likewise requires personal information, a history of driving experience, and health assessments. Both the CDL Application and the Oregon 440 2570 form emphasize safety and competence in professions where poor performance can have serious consequences.

The application for a Teaching License, used in states like Ohio, demands comprehensive information on educational background, teaching experiences, and moral character affirmations akin to those in the Oregon 440 2570 form. Both underscore the importance of ensuring individuals are suitably qualified and committed to ethical practice before entrusting them with professional responsibilities.

Lastly, the application process for a Pilot's License, overseen by the Federal Aviation Administration (FAA), parallels the Oregon 440 2570 form by requiring rigorous verification of training, experience, and competence. Both types of applications serve the dual purpose of safeguarding public welfare while setting a high bar for entry into the profession, reflecting the societal value placed on these roles.

In essence, while the fields and specifics of these documents vary broadly, they collectively illustrate the universally meticulous process of professional licensure. These processes, including the one detailed by the Oregon 440 2570 form, are designed to ensure that only those individuals who meet stringent, standardized criteria can enter and remain within these vital professions.

Dos and Don'ts

When filling out the Oregon 440-2570 form for an Electrical License Application, it is important to navigate the details carefully to ensure accuracy and compliance with the Department of Consumer & Business Services requirements. Below are lists of things you should and shouldn't do during this process.

Things You Should Do

  1. Read the application instructions carefully before you start filling out the form to make sure you understand all requirements.

  2. Complete all steps of the application, ensuring that each section is filled out correctly and thoroughly.

  3. Provide your Social Security number as required by ORS 25.785 for all BCD licenses, certifications, and registrations. This information is crucial for your application to be processed.

  4. Attach a 2” x 2” passport-style photo with your name written on the back as specified in Step 7 of the application instructions. Remember not to staple the photo to the form.

  5. Sign and date the affidavit in Step 8, affirming that all the information provided in the application is complete and correct to the best of your knowledge.

Things You Shouldn't Do

  1. Do not leave any sections incomplete. Filling out all relevant sections of the form is essential for your application to be considered.

  2. Avoid guessing dates or details when listing previous licenses or employment history. Inaccuracies can lead to application processing delays or denials.

  3. Do not send cash. Make payments using check, money order, or credit card as directed in the application instructions.

  4. Refrain from stapling any documents together, including your passport-style photo, to ensure that all parts of your application remain easily accessible for processing.

  5. Avoid falsifying any information on the application or related verification forms. Deliberate falsifications can lead to license suspension, revocation, or denial of the application.

Misconceptions

When navigating the Oregon 440-2570 form for electrical license application, it's easy to encounter misunderstandings. Here's a list of common misconceptions and clarifications:

  • It's only for new applicants: This form is necessary not only for first-time applicants but also for those renewing or upgrading their licenses.
  • Personal information isn't shared: While the form requires your Social Security number, it clarifies that this information is strictly for official use, complying with legal requirements and might be shared only with authorities for specific purposes.
  • You can choose any license type regardless of experience: The form lists various license types, each with its own set of prerequisites and scope. It's important to select the one that matches your training and experience.
  • Testing locations are flexible: Applicants must refer to a provided list or the official website to choose a test location, indicating that there are designated places where testing is conducted and cannot be arbitrarily chosen.
  • Payment methods are limited: The form accepts several forms of payment, including checks, money orders, and major credit cards, providing flexibility for applicants in how they pay the required fees.
  • Work experience section is just a formality: This section is critical as it must be filled accurately with detailed information regarding prior employment. This data is part of the verification process to ensure eligibility for the applied license.
  • All applicants must submit a photograph: Yes, a passport-style photo is a requirement for the application process. This photo will be used on your license, highlighting the importance of this step for identification purposes.
  • The affidavit is optional: Signing and dating the affidavit is a compulsory step in the application process, asserting that all provided information is accurate and understanding the consequences of falsification.

Understanding these key aspects of the Oregon 440-2570 form ensures a smoother application process for electrical licensure, avoiding common mistakes that can delay or impact the outcome of the application.

Key takeaways

When you're preparing to fill out the Oregon 440 2570 form for electrical licensure, there are several important steps and requirements you need to be aware of. Understanding these key takeaways can streamline the process, ensuring you provide all the necessary information accurately and efficiently. From the application itself to supplementary documentation, here’s a breakdown of what you need to know:

  • Complete Personal Information Thoroughly: Step 1 requires you to provide detailed personal information, including your Social Security number. This is essential for BCD (Building Codes Division) licensure and certifications, primarily for tax administration and child support enforcement purposes.

  • Report Previous Licenses: If you hold or have held electrical licenses in any state, you must list these in Step 2. Including copies of all out-of-state licenses with your application is mandatory, demonstrating your history and qualifications in the field of electrical work.

  • Select the Appropriate License Type: Step 3 highlights the importance of choosing the correct license type for your work. Each license has specific requirements and a set scope, with nonrefundable fees attached. Make sure to review the application instructions to select the license category that best fits your qualifications and field of expertise.

  • Provide Comprehensive Employment History: Detailed employment history is crucial for verifying your experience in the electrical field. You need to list all relevant positions, starting with the most recent. For spaces that require more information than provided, attach additional sheets. This step helps the licensing board understand the breadth and depth of your professional experience.

  • Verification of Work Experience: Step 6 and the Electrical Experience Verification form (440-2570A) are vital. You must submit a separate verification form for each employer, along with any additional documentation that substantiates your work experience, such as military service, apprenticeship, or training programs. This documentation is crucial for the validation of the hands-on experience you’ve gained over the years.

  • Include a Photograph and Complete the Applicant Affidavit: A 2” x 2” passport-style photo is required (Step 7), with your name on the back, to be used on your license. Stapling the photo is not allowed. Furthermore, the applicant affidavit (Step 8) requires your certification that all information provided is complete and correct, under penalty of license suspension, conditioning, or revocation for falsifications.

  • Review the Checklist Before Submission: Step 9 provides a comprehensive checklist for applicants, ensuring you have not missed any crucial steps. This includes the completion of the application form, signing the affidavit, providing work experience verification from each employer, submitting additional documentation as required, and including the passport-style photo with payment.

Adhering to these guidelines and carefully reviewing every section of the form will aid in a smooth application process. Remember, accuracy and attention to detail can significantly influence the outcome of your electrical license application in Oregon.

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