Trade License Application
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1TRADE LICENSE APPLICATION
221 N. Figueroa St., Room 700
Los Angeles, CA 90012
(213) 482-0099
Examination Title:
Date:
Applicant Name:
Birth Date:
Address:
Address
City
State
Zip
Email:
Phone:
Height:
Weight:
Eyes:
Hair:
Employer – Name and Address
Duties Related to Examination
Dates
Total Time
* Only show experience needed to qualify for examination
From:
YEARS/MOS
To:
From:
YEARS/MOS
To:
From:
YEARS/MOS
To:
From:
YEARS/MOS
To:
From:
YEARS/MOS
To:
I hereby certify that all of the information that I have given herein is true and complete to the best of my knowledge and
belief. I understand that any false statement will subject me to disqualification. *CERTIFIED WELDER APPLICANTS: By
signing below you authorize the Department to post your photo and license information on our website upon issuance of license.
Applicant’s Full Signature
FOR OFFICE USE ONLY:
EXAM NUMBER
EXAM STATUS
Exam Date
Oral
LICENSE NUMBER
Written
Final
Initial
For Cashier’s Use Only
2
Fees (if
nd
FEES
applicable)
Approved for Exam By
Filing Fee
One Stop Surcharge
System Surcharge
Total Fees Due
As a covered entity under Title II of the Americans with Disabilities Act, the City of Los Angeles does not discriminate on the basis of disability, and upon
request, will provide reasonable accommodation to ensure equal access to its programs, services and activities.
Applications valid for six months
IN.App29 (Rev. 03-11-2016)
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