Free Oregon 440 2570 PDF Form

The Oregon 440 2570 form is an essential document for professionals in the electrical field within the state, serving as the official Electrical License Application. This comprehensive form, overseen by the Department of Consumer and Business Services' Building Codes Division, requires detailed information from applicants ranging from personal details to proof of work experience and previous licensure. The careful completion of this document, along with the submission of necessary verification forms and payment, marks the first step towards achieving or renewing an Oregon electrical license.

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The Oregon 440 2570 form serves as a pivotal document for individuals seeking to obtain or renew an electrical license within the state. Managed by the Department of Consumer & Business Services through its Building Codes Division, this comprehensive application requires detailed information from applicants to ensure adherence to state regulations and standards. It mandates the submission of personal details, past license history, and a selection of license types, each with specific fees that are nonrefundable. Moreover, the procedure involves selecting a preferred testing location, stating employment history in detail to verify experience, and, crucially, providing proof of said experience via a separate Electrical Experience Verification form (440-2570A) or, for those with military experience, equivalent official documentation. Additionally, it necessitates the submission of a passport-style photograph, which will be featured on the issued license. The form emphasizes the importance of honesty, warning that any falsification may lead to the suspension, conditioning, or revocation of the license. Applicants are guided through each step with a checklist, ensuring all requirements are met before submission, including the affidavit to affirm the accuracy of the information provided. This process underscores the state’s commitment to maintaining high standards within the electrical sector, ensuring that all licensed professionals possess the necessary qualifications and experience.

Document Example

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.

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

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:
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	Design, plan, and lay out work; sign all	8,000 hours of on-the-job journeyman experience.
General supervising	permits; licensee is the only individual	8,000 hours of on-the-job journeyman experience.
electrician	permits; licensee is the only individual	OR
electrician	authorized to direct, supervise, or control	OR
(S)	authorized to direct, supervise, or control	(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.	journeyman electrician and provide verification of an
OAR 918-282-0140
		additional 8,000 hours of on-the-job journeyman
		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
OAR 918-282-0160
	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.)
OAR 918-282-0170		OR
	work requiring no supervision.	OR
		(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
Reciprocal general	permits; licensee is the only individual	that has a reciprocal licensing agreement with Oregon.
supervising electrician	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)	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	the installation or alteration of an	reciprocal agreements and the application form, Reciprocal
OAR 918-030-0045	electrical service.	Electrical and Plumbing License Application.
	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	(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	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	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	reciprocal agreements and the application form, Reciprocal
	work requiring no supervision.	Electrical and Plumbing License Application.
	work requiring no supervision.

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	Make electrical installations on one- and	(2)	Official transcripts verifying 288 hours of classroom
Limited residential	two-family or multifamily dwelling		training AND verification of 4,000 hours of on-the-job
electrician	units, not exceeding three floors above		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		residential experience obtained outside of Oregon.
(LR)	grade. (Must work under the		(300 percent rule applies.)
	supervision, direction, and control of a		(300 percent rule applies.)
OAR 918-282-0180	supervision, direction, and control of a		OR
OAR 918-282-0180	general supervising electrician.)		OR
	general supervising electrician.)	(3)	Verification of 8,000 hours of on-the-job residential
		(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
	Install, maintain, replace, and repair		in Oregon.
	electrical wiring and electrical products		in Oregon.
	electrical wiring and electrical products		OR
	on or in an existing operable		OR
Limited journeyman	on or in an existing operable	(2)	Official transcripts verifying 576 hours of classroom
Limited journeyman	manufacturing plant or industrial plant	(2)	Official transcripts verifying 576 hours of classroom
manufacturing plant	manufacturing plant or industrial plant		training AND verification of 8,000 hours of on-the-job
manufacturing plant	owned or used by employer. (Must work		training AND verification of 8,000 hours of on-the-job
electrician	owned or used by employer. (Must work		commercial and industrial experience obtained outside
electrician	under the supervision, direction, and		commercial and industrial experience obtained outside
(PJ)	under the supervision, direction, and		of Oregon. (300 percent rule applies.)
(PJ)	control of a limited supervising		of Oregon. (300 percent rule applies.)
	control of a limited supervising		OR
OAR 918-282-0190	electrician. If there is no supervising		OR
OAR 918-282-0190			Verification of 16,000 hours of on-the-job commercial
		(3)
	electrician, licensee is limited to repair	(3)
	electrician, licensee is limited to repair		and industrial experience obtained outside of Oregon.
	and maintenance work.)		and industrial experience obtained outside of Oregon.
	and maintenance work.)		(300 percent rule applies.)
			(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.)
OAR 918-282-0205

		(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	Install and service electrical signs and		verification of 4,000 hours of on-the-job sign
electrician	outline lighting. (Must be employed by a		verification of 4,000 hours of on-the-job sign
(SIG)	outline lighting. (Must be employed by a		electrical experience obtained outside of Oregon.
(SIG)	limited sign contractor.)		electrical experience obtained outside of Oregon.
	limited sign contractor.)		OR
OAR 918-282-0220			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
Limited journeyman	shows, exhibits, displays, festivals,		on-the-job experience obtained outside of Oregon.
stage electrician	shows, exhibits, displays, festivals,		on-the-job experience obtained outside of Oregon.
stage electrician	conventions, stage, theater, film, or video		OR
(ST)	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	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
	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
OAR 918-282-0240
	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,	(1)	Completion of an approved one-year training program
	appliances, light switches and fixtures,		in Oregon.
	fans, receptacles, and fluorescent		in Oregon.
Limited building	fans, receptacles, and fluorescent		OR
Limited building	ballasts on the premises of commercial		OR
maintenance electrician	ballasts on the premises of commercial	(2)	Verification of 2,000 hours of on-the-job training or
maintenance electrician	office buildings, buildings occupied by	(2)	Verification of 2,000 hours of on-the-job training or
(BME)	office buildings, buildings occupied by		experience in maintenance, repair, and replacement of
(BME)	the state or a local government entity,		experience in maintenance, repair, and replacement of
OAR 918-282-0260	the state or a local government entity,		electrical appliances, light switches, light fixtures,
OAR 918-282-0260	and facilities designated by the Electrical		electrical appliances, light switches, light fixtures,
	and facilities designated by the Electrical		fans, receptacles, and fluorescent ballasts. (300
	and Elevator Board in electrical systems		fans, receptacles, and fluorescent ballasts. (300
	and Elevator Board in electrical systems		percent rule applies.)
	not exceeding 300 volts to ground.		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
(LEA)	limited energy contractor, or for one		obtained outside of Oregon, broken down into specific
OAR 918-282-0345	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	Perform limited energy electrical		broken down into specific work categories (300
Limited energy	activity that does not include protective		broken down into specific work categories (300
technician,	activity that does not include protective		percent rule applies) AND
technician,	signaling. (An LEB must be licensed as		percent rule applies) AND
Class B	signaling. (An LEB must be licensed as		(b) Completion of a board-approved 32-hour training
Class B	an electrical contractor, or must work for		(b) Completion of a board-approved 32-hour training
(LEB)	an electrical contractor, or must work for		program (may be taken after application is
	an electrical contractor, limited energy		program (may be taken after application is
			approved).

OAR 918-282-0360	contractor, or for one employer in an
OAR 918-282-0360
OAR 918-282-0365			OR
	industrial plant.)		OR

		(3)	Verification of 8,000 hours of work experience
		(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.
Limited maintenance			OR
manufactured structures	Repair or maintain electrical wiring and		OR
manufactured structures	Repair or maintain electrical wiring and	(2)	Two years of employment as a limited-maintenance
(LMM)	equipment in manufactured structures.	(2)	Two years of employment as a limited-maintenance
(LMM)	equipment in manufactured structures.		manufactured-structures trainee working with a
OAR 918-282-0250			manufactured-structures trainee working with a
OAR 918-282-0250			licensee or for an employer of a licensee.
			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

Download PDF File

File Features

Fact Name	Fact Detail
Form Purpose	The Oregon 440-2570 form is used for the application of various electrical licenses.
Required Information	Applicants must provide personal details, previous licenses, selected license type, test location (if applicable), employment history, and a photograph.
Submission Requirement	The form, along with the verification of work experience and the application fee, must be mailed to the Department of Consumer & Business Services.
Governing Laws	The form and its processes are governed by Oregon Revised Statutes (ORS) 25.785, ORS 305.385, and relevant rules in the Oregon Administrative Rules (OAR), specifically OAR 918-001-0040 for application denial based on false information.

Oregon 440 2570: Usage Guide

Filling out the Oregon 440-2570 form is essential for anyone seeking an electrical license in the state. This document is your gateway to becoming a licensed electrician, allowing you to work legally within Oregon. The process requires attention to detail to ensure each section is completed accurately. The form not only asks for your personal and professional information but also details your work experience and qualifications in the electrical field. Before submitting, you'll need to gather relevant documents to support your application. Follow the steps below to complete the form correctly.

Applicant Information: Fill in your name, address (street or P.O. Box, city, state, ZIP code), phone number, fax (if applicable), and email. Make sure to include your Social Security number, as it's required for the application process.
Previous Licenses: List all individual or contractor electrical licenses you have held, including those from other states. Attach copies of these out-of-state licenses with your application.
License Type: Select the license type you are applying for and note the respective fee next to it. Remember that these fees are non-refundable.
Test Location: Choose a preferred testing location from the list provided or the website. If you are a reciprocal applicant (i.e., you already have a license from another state that has an agreement with Oregon), note that you do not need to take a test.
Employment History: Provide details of your work experience, starting with your current or most recent job. Include the employer's name, period of employment, hours worked per week, and supervisor's information. Describe the work performed in each role. Attach additional sheets if more space is needed.
Verification of Work Experience: Submit an Electrical Experience Verification form (440-2570A) from each of your employers. If your work experience includes military service, submit official documentation from your supervising official and other reliable documentation verifying your training and experience.
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.
Applicant Affidavit: Read the statements provided and sign the affidavit, certifying that the information you have provided is complete and correct. Note the repercussions of providing false information or cheating on a licensing examination.
Checklist for Applicants: Before submitting, ensure you have completed all sections of the form, signed the affidavit, provided verification of work experience, attached additional documentation if necessary, included your passport-style photo, and prepared the correct fee payment.

Once everything is in order, mail your application with the payment to the indicated address. Ensure that all documentation is clear and accurate to avoid any delays in processing your application. After submission, you can look forward to the next steps in securing your electrical license in Oregon, paving the way for a successful career in the electrical trade.

Crucial Points on Oregon 440 2570

What are the requirements for submitting an Oregon 440 2570 Electrical License Application?

To submit an Oregon 440 2570 Electrical License Application, applicants must follow several critical steps:

Complete the application form with all required information, including Applicant Information, Previous Licenses, License Type, and Test Location.
Submit a Verification of Work Experience form (440-2570A) for each employer or provide official documentation if relying on military experience.
Provide a 2”x2” passport-style photo with the applicant's name on the back. Do not staple the photo to the application.
Sign and date the Applicant Affidavit verifying the accuracy and completeness of the application.
Ensure all relevant application fees are paid, depending on the chosen license type.

How do I verify my work experience for the 440 2570 form?

To verify work experience for the Oregon 440 2570 form, applicants are required to:

Submit an Electrical Experience Verification form (440-2570A) for each employment position held. This includes filling out the applicant's information, period of employment, and verifier information. Each verifier must confirm the work experience detailed in the form.
If relying on military experience, applicants must provide official documentation from a supervising official detailing the type and approximate hours of work experience, along with any other reliable documentation verifying the experience and training conducted.

What should I do if I want to pay my application fee by credit card?

Applicants wishing to pay their application fee by credit card for the Oregon 440 2570 form must follow these steps:

Complete the credit card information section on the application form, which includes providing the credit card number, expiration date, and the name of the cardholder as shown on the credit card.
Ensure the cardholder signs the application form to authorize the payment.
Applicants are advised to use the secure fax number provided (503-947-2333) for credit card payments to protect their information.

Note: Cash payments are not accepted, so applicants must choose between paying with a check, money order, or credit card.

How can I submit my Oregon 440 2570 Electrical License Application and accompanying documents?

To submit your Oregon 440 2570 Electrical License Application and any accompanying documents, such as the Electrical Experience Verification form (440-2570A) or proof of military experience, follow these instructions:

Mail the completed application form along with payment and any required documents to the specified address: DCBS Fiscal Services, Department of Consumer & Business Services, P.O. Box 14610, Salem, OR 97309-0445.
Ensure all documents are filled out completely and accurately before sending. Incomplete applications or missing documentation can result in processing delays or application refusal.
For credit card payments, the secure fax method is recommended for added security.

Remember to keep copies of all documents submitted for your records.

Common mistakes

When filling out the Oregon 440 2570 form for an electrical license application, people often miss or make errors in several key areas. Paying attention to these common mistakes can smooth the application process and help avoid delays. Here are nine of the most frequent pitfalls:

Not providing complete applicant information in Step 1, especially missing details like the full address or Social Security number, which is mandatory for background checks.
Forgetting to list all previous licenses in Step 2 or neglecting to submit copies of out-of-state licenses, which can hinder the verification process.
Selecting the wrong license type in Step 3 or not clearly indicating their choice, leading to processing delays or incorrect fee assessments.
Skipping the indication of a preferred test location in Step 4, which can result in being assigned to a less convenient location or additional administrative follow-ups.
Providing incomplete employment history in Step 5, such as missing dates or inadequate descriptions of the work performed, which are crucial for verifying relevant experience.
Omitting or submitting incomplete Electrical Experience Verification forms (440-2570A) for each employment period mentioned, as required in Step 6, which can significantly delay application processing.
Failing to attach a 2” x 2” passport-style photo in Step 7 or stapling it to the form despite instructions to the contrary, risking damage to the photo or the application.
In Step 8, neglecting to sign and date the applicant affidavit, which is a critical oversight as unsigned applications are considered incomplete.
Overlooking the checklist for applicants in Step 9, leading to submissions without the necessary documentation, such as verification of work experience or proof of apprenticeship completion.

Additionally, below are common errors found in the broader sections of the application process:

Misunderstanding the fee structure and submitting the wrong amount, which can be based on the license type. This misstep can delay processing until the correct fees are paid.
Forgetting to list an applicant name on every page of the form, causing confusion and potentially misplacing pages during processing.
Assuming reciprocity without verifying, as some applicants may incorrectly believe that holding a license in another state automatically qualifies them in Oregon, neglecting the need for official documentation or further testing.

Taking the time to carefully review each section of the form, providing all requested documentation, and double-checking that all steps are completed can help ensure a smoother application process.

Documents used along the form

The Oregon 440 2570 form, an essential application for various electrical licenses, necessitates several supplementary documents throughout the application process. These additional forms and documents are vital in ensuring a comprehensive and compliant application, showcasing the applicant's qualifications, experience, and readiness for the responsibilities the license entails.

Electrical Experience Verification Form (440-2570A): This form is critical for validating the applicant’s hands-on work experience in the electrical field. Each employer must provide a detailed account of the applicant's duties and the duration of their employment to attest to their qualifications.
Proof of Apprenticeship Completion: Applicants must furnish documentation confirming the completion of an Oregon-approved electrician apprenticeship or a training program recognized by the state. This serves as a testament to the applicant's foundational knowledge and skills.
Official Transcripts: These are required for verifying the successful completion of classroom training, which complements practical experience. Transcripts must come from accredited institutions and showcase relevant coursework.
High School Diploma, GED, or Equivalent: A basic educational foundation is necessary, with a high school diploma, GED, or an equivalent credential being the minimum requirement. This document demonstrates the applicant's ability to understand and follow complex instructions.
Passport-style Photo: A 2” x 2” photo is essential for identification purposes. This photograph will be attached to the issued license, helping to verify the identity of the holder.
Payment Proof: Submission of the applicable fee is crucial for the processing of the application. Proof of payment, whether through check, money order, or credit card, ensures that the application can proceed through the necessary channels.
Copy of Out-of-State Licenses: For applicants who hold or have held electrical licenses in other states, copies of these licenses must be submitted. This documentation supports the assessment of the applicant’s qualifications and readiness to hold an Oregon electrical license.

Each of these documents plays a pivotal role in the Oregon 440 2570 application process, providing a comprehensive picture of the applicant's qualifications, experience, and readiness to hold an electrical license. Together, they ensure that the application meets the rigorous standards set forth by the Department of Consumer & Business Services, paving the way for a successful and compliant licensure.

Similar forms

The Oregon 440 2570 form is similar to a Contractor License Application used in many states. Both forms require detailed personal information, proof of experience, and past licenses to evaluate the applicant's qualifications. The Contractor License Application often demands a record of previous projects and any certifications relevant to the specific trade, much like the Oregon 440 2570 form asks for a list of all electrical licenses held by the applicant. Both forms play a crucial role in ensuring that only qualified individuals are authorized to perform specific work, thereby upholding industry standards and safety.

Another document resembling the Oregon 440 2570 form is the Professional Engineer License Application. This form, like the 440 2570, mandates applicants to provide comprehensive information about their educational background, work experience, and any prior licenses. Both applications require verification of qualifications and include an affidavit section where the applicant must affirm the truthfulness of the information provided. The focus on verifying qualifications underscores the importance of integrity and competence in professions that significantly impact public safety and welfare.

The Medical License Application shares similarities with the Oregon 440 2570 form in several ways. Both require applicants to disclose detailed personal and professional history, including a comprehensive record of education and work experience. Each form necessitates an affidavit from the applicant, confirming the accuracy of the information provided. Additionally, the requirement for a passport-style photo is common to both, used for identification purposes upon successful licensing. These procedures ensure that only properly vetted and qualified professionals are entrusted with critical responsibilities.

Additionally, the Commercial Driver’s License (CDL) Application exhibits parallels to the Oregon 440 2570 form. Both forms require detailed personal information, a history of previous licenses, and, most notably, a section dedicated to verifying practical experience related to the license being applied for. For the CDL application, this may include logging driving hours, while for the Oregon 440 2570 form, it involves documenting electrical work experience. Each form plays a significant role in maintaining safety standards within their respective fields by ensuring that applicants possess the necessary skills and experience.

The Real Estate License Application is another document similar to the Oregon 440 2570 form. Applicants are required to provide comprehensive personal information, a list of any past professional licenses, and detailed employment history, similar to the electrical license application. Both applications include steps for verifying the applicant’s experience in the field, highlighting the emphasis on qualified and experienced individuals serving the public in these professional capacities.

A Teaching Credential Application also shares features with the Oregon 440 2570 form. Each demands extensive information on the applicant's educational background, work experiences, and any other licenses or credentials previously obtained. Additionally, they both include an affidavit section where the truthfulness of the provided information must be confirmed by the applicant. This process ensures that only those with the proper qualifications and moral integrity are granted the authority to teach or perform electrical work, respectively.

Lastly, the Cosmetology License Application has aspects in common with the Oregon 440 2570 form. Both applications ask for detailed personal and professional information, including previous work experience and any licenses held in the same or different states. They both place a strong emphasis on the verification of qualifications and include an affidavit to assert the accuracy of the information provided by the applicant. This thorough vetting process is crucial in fields where professionals directly serve the public and must meet specific standards of expertise and ethics.

Dos and Don'ts

When you're completing the Oregon 440-2570 form, which is the Electrical License Application, it's critical to follow a set of do's and don'ts to ensure your application is processed smoothly. Below are specific guidelines that applicants should adhere to:

Do:

Read the entire application and its instructions carefully before you start filling it out. This ensures you understand the requirements and reduces the chance of mistakes.
Complete all sections of the application. Incomplete applications can delay the process or lead to denial. Pay special attention to your social security number, which is mandatory.
Include a copy of all your out-of-state licenses if you're required to list previous licenses under STEP 2. This provides the necessary verification for your application.
Make sure your application fee payment is accurate according to the license type you're applying for. Payment details should be filled out correctly to avoid processing delays.

Don't:

Use a pencil or erasable ink when filling out the form. All entries should be made in permanent ink or typed to ensure they are legible and permanent.
Staple your photo to the application. Photos should be submitted without stapling, as specified in STEP 7, to avoid damage to the photograph or the application form.
Forget to sign and date the applicant affidavit in STEP 8. This is a crucial step in affirming the accuracy and truthfulness of your application.
Omit the verification of work experience (Form 440-2570A) from each of your employers, as required. This documentation is essential for validating your reported experience.

Adhering to these guidelines can facilitate a smoother application process, helping you to avoid common pitfalls that can delay or jeopardize your application's approval.

Misconceptions

When it comes to navigating the requirements for the Oregon 440-2570 form, several misunderstandings commonly arise. By clarifying these misconceptions, applicants can navigate the application process more smoothly and ensure their submissions are completed accurately.

Misconception #1: Social Security Number (SSn) is Optional
One common misunderstanding is that providing a Social Security Number (SSN) on the application is optional. In reality, an SSN is mandatory for BCD licenses, certifications, and registrations. This requirement, grounded in ORS 25.785, aids in tax administration and child-support enforcement.
Misconception #2: Experience Verification Forms Aren't Always Required
Another error applicants often make is assuming that the Electrical Experience Verification form (440-2570A) is not always necessary. However, this form is crucial for verifying work experience with every employer listed in the applicant's employment history or for providing official documentation of military experience.
Misconception #3: Any Type of Photo is Acceptable for Submission
There's also a belief that any photograph can be submitted with the application. Yet, the application specifies that a 2” x 2” passport-style photo is required, with the applicant's name written on the back. This requirement ensures the photo on the license is appropriate and meets the standard formatting.
Misconception #4: Fees Are Refundable
Many think that if their application is refused or withdrawn, they can get a refund of the fee paid. However, fees submitted with the application are nonrefundable regardless of the application's outcome, as noted in the instructions and the fees section.
Misconception #5: Out-of-state Licenses Automatically Qualify for Reciprocity
Applicants sometimes believe that holding an out-of-state license means they automatically qualify for an Oregon license under reciprocity. While the form asks for a list of such licenses, each is subject to verification and must meet Oregon's reciprocal licensing agreements.
Misconception #6: Cheating or Providing False Information Has Minor Consequences
Some individuals underestimate the severity of providing false information or cheating on the licensing examination. The consequences are significant, leading to application denial and a one-year bar from applying for any license or taking any division-related examination.
Misconception #7: Previous Licenses Do Not Need to Be Listed If They Are Expired
A final common oversight is the belief that only current licenses need to be reported. However, the application requires listing all individual or contractor electrical licenses held in any state, expired or active, to provide a complete licensing history.

By addressing these misconceptions, individuals can better prepare their Oregon 440-2570 form submissions, ensuring a smoother application process and improving their chances of success.

Key takeaways

Filling out the Oregon 440 2570 form is a critical step for individuals seeking to obtain or renew an electrical license in Oregon. Here are key takeaways to ensure the process is handled accurately:

Before completing the application, it’s imperative to thoroughly read the instructions provided to avoid any errors or omissions that could delay the licensing process.
Applicant’s personal information, including their Social Security number, is required for identification and verification purposes, in compliance with both state and federal regulations.
Listing all previous and current electrical licenses, including those from other states, is necessary and copies of these licenses must be submitted with the application.
Selecting the correct license type is crucial as it determines the scope of work the applicant is authorized to perform, and each license type has specific requirements and fees.
Choosing a preferred testing location is mandatory, except for reciprocal applicants who are exempt from testing based on agreements between states.
Documenting employment history comprehensively, including positions held, duties performed, and the duration of employment, showcases the applicant's experience in the electrical field.
Verification of work experience through the Electrical Experience Verification form (440-2570A) or equivalent documentation for military experience is essential for proving the applicant's qualifications.
Submission of a 2” x 2” passport-style photo with the application is required; this photo will be used on the issued license.
The applicant must sign an affidavit asserting the accuracy and completeness of the information provided in the application, acknowledging the consequences of providing false information.
Completion of an apprentice program, or equivalent educational qualifications, must be substantiated with documentation to satisfy specific license requirements.
Payment of the appropriate fee, correlating with the selected license type, must accompany the application. Payment options include check, money order, or credit card.

It is important for applicants to follow these guidelines carefully and provide all requested documentation to ensure their application is processed without unnecessary delays. The Department of Consumer & Business Services offers further assistance and resources on their website for those who need additional guidance.

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