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Jason Hagopianm ,MIAMIBEACH NAME; Hagopian Last Name HOME ADDRESS: 644'4' A No. PHONe: 305.215.2739 Home CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM Jason R First Name Middle Initial Ilison Road Miami Beach FL 33139 Street City State Zip Code 305.576.2006 305.576.2005 jagopian@tsaodesign. Work Fax Email address Business Name: TSAO Design Group Position: Principal Address: 4040 NE 2nd Ave Suite 314 Miami FL 33137 No. Street City State Zip Code Professional License (describe) State Of FL LICenSed ArChlteCt #AR91288 Expires: 02.28.09 Attach a copy of the license Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated with the city; this requirement shall be fulfilled in the following ways: a) an individual shall have been a resident of the city for a minimum of six months; or b) an individual shall demonstrate ownership/interest for a minimum of six months in a business established in the city. • Resident of Miami Beach for a minimum of six (6) months: Yes or No '- • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: Yes)G or No !:_ • Are you a registered voter in Miami Beach: Yes ~ or No ==.i • (Please circle one): I am now a resident of: ~orth Beach South Beach Middle Beach • I am applying for an appointment because I have special abilities, knowledge, experience. Please list below: 17+ years experience~in design and Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three f3) choices will be observed by the City Clerk's Office. (Regular Boards of City) `1 Affordable Housin Adviso Committee ^ Historic Preservation Board* ^ Art in Public Places Committee ^Housin Authorit " ^ Beach Preservation Board ^ Loan Review Committee' ^ Beautification Committee ^ Marine Authori " ^ Board of Ad'ustment` ^ Miami Beach Commission for Women ^ Bud et Adviso Committee ^ Miami Beach Cultural Arts Council ^ Ca ital Im rovements Oversi ht ^ Miami Beach Florida Sister Cities ^ Committee on Homeless ^ Normand Shores Local Gov't Nei h. Im rovement ^ Committee for Qualit Education in MB ^ Parks and Recreation Facilities Board ^ Communit Develo ment Adviso ^ Personnel Board` ^Communit Relations Board ^ Plannin Board ^ Convention Center Adviso Board ^ Police Citizens Relations Committee ^ Cultural Arts Nei hborhood District Overla CANDO ^ Production Indust Council ^ Debarment Committee ^ Public Safet Adviso Committee Desi n Review Board" ^ Safet Committee ^ Disabilit Access Committee ^ Sin le Famil Residential Review Panel ^ Fine Arts Board ^ Sustainabilit Committee ^ Ga Business Develo ment Ad Hoc ^ Trans arenc Reliabilit & Accountabilit Committee "TRAC" ^ Golf Adviso Committee ^ Trans ortation and Parkin Committee ^ Health Adviso Committee ^ Visitor and Convention Authorit " ^ Health Facilities Authorit Board ^ Youth Center Adviso Board O His anic Affairs Committee " Board Re wired to File State Disclosure form \. _ ~ S~?,..:.1~uaic ~ .:r,mi~n,t _ ,At3~ - •.c?PI~r 3n i>>k~_ ",p~~lic~l .,r: F2evi1-~ 1' 13~)~~_uOr Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board: Yes ~ No C, Years of Service: 2. Present participation in Youth Center activities by your children Yes- No ._. If yes, please list the names of your children, their ages, and which programs. List below: Child's name: Age: Program: Child's name: Age: Program: .Have you ever been convicted of a felony: Yes ~ ~ or NoX If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: Yes ~'~ or NoX. If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money: Yes -, or Nod. If yes, explain in detail • Are you currently serving on any City Boards or Committees: Yes _~ or No ~ If yes; which board? • What organizations in the City of Miami Beach do you currently hold membership in? Name: Miami Beach Chamber of Commerce Name: Title: Chair of the Pillar Trustee Board Title: • List all properties owned or have an interest in, which are located within the City of Miami Beach: • I am now employed by the City of Miami Beach: Yes :- or Nod( Which department? • Pursuant to City Code Section 2-25 (b): Do you have a parent _~, spouse ~, child :-, brother ~~, or sister ^ who is employed by the City of Miami Beach? Check all that apply. Identify the department(s): This section is "not required" but desired: Age: 41 years old Gender: Male fg Female ^ Ethnic Origin (Check one) White African-American/Black ^ Hispanic: ^ Asian or Pacific Islander ^ American Indian or Alaskan Native ^ "I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, Article VII - of the City Code "Standards of Conduct for City Officers, Employees and Agency Members." ~ 01/14/09 Jason Hagopian Applicant's Sign ture Date Name of Applicant (PLEASE PRINT) Please attach a copy of your resume to this application NOTE: Applications will remain on file for a period of one (1) calendar year. Employment Status: Employed ^ Retired ^ Home- er ^ Ot er ^ / Received in City Clerk's Office by 1~`Z" `~~ ate l Name of Deputy Clerk ~ ~ ~' Document Control Number (Assigned by the City Clerk's Office) ?~Z~ Entered By Date Revise 09!02/08 LH F:': r rt 5~1. ~i>oait! ~..,,,i~~twi1 es\i3~`s '~ppl~%, rn F;~, -~~~t~L(:HL. i ~•^si4 t' l , c;r~ { sf3!^`s~j~~.o~ ~71HIC Vr rLVRIL/H ~~"" -~= ;s ~~ DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ~~ ~1' BOARD OF ARCHITECTURE & INTERIOR DESIGN (850) 487-1395 ~:,,:,.~o~t~' 1940 NORTH MONROE STREET ''••~..._. TALLAHASSEE FL 32399-0783 HAGOPIAN, JASON RONALD 6444 ALLISON RD MIAMI BEACH FL 33141 STATE OF FLORIDA AC# 3 ~ 3 5 ~ 2 9 ~~ DEPARTMENT OF BUSINESS AND \~i PROFESSIONAL REGULATION AR91288 01/18/07 060479282 ARCHITECT HAGOPIAN, JASON RONALD IS LICENSED under the provieionn of Ch.481 FS. Szplratioa date: FEB 28, 2009 L07011800802 DETACH HERE ~ AC# ~ ~ 3 5 ~ 2 9 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION j BOARD -0F .ARCHITECTURE & INTERIOR DESIGN SEQ#L07o11s008o2 1/18/20071060479282 IAR91288 The ARCHITECT Named below IS LICENSED Under the provisions of Chapter 481 FS. Expiration date: FEB 28, 2009 HAGOPIAN, JASON RONALD 6444 ALLISON RD - MIAMI BEACH FL 33141 ', CHARLIE GRIST HOLLY BENSON GOVERNOR DISPt_AY AS REQUIRED BY lAW SECRETARY JASON HAGOPIAN, AtA, NCARB, LEED AP Principal EXPERIENCE Jason Hagopian is a principal of TSAO Design Group and established the firm's offices on the east cost in Miami Beach, Award winning designer, registered architect and LEED Accredited Professional, Jason has extensive experience in corporate, retail, institutional and residential projects throughout the United States, Canada, and South America, Jason's leadership extends beyond his executive responsibilities as managing principal and includes active participation in the planning, design and production of projects. Under his direction, the firm was named a Top Minority Business in South Florida for two consecutive years by the Greater Miami Chamber of Commerce, and Jason was inducted into the Stars of Design 2007 by DCOTA, the Design Center of The Americas for his philanthropic support of underserved communities. EDUCATION Bachelor of Building Science, 1991 School of Architecture Rensselaer Polytechnic Institute Troy, New York Bachelor of Architecture, 1991 School of Architecture Rensselaer Polytechnic Institute Troy, New York CERTIFICATIONS Registered Architect, State of California License Number C27694 Registered Architect, State of Florida License Number AR91288 LEED Accredited Professional, USGBC AFFILIATIONS Member, American Institute of Architects National Council of Architectural Registration Boards MAJOR CLIENTS Best Buy Citibank Charles Schwab Great Florida Bank TotalBank ALDO Miami-Dade GSA Miami-Dade Aviation Dept TSAO Des~gnGroup