20120210105133710.pdfLetter of Transmittal
February 7, 2012
Washington State Departinent of
L-jealth
Construction Review Services
310 Israel Rd. SE
Tumwater, WA 98501
PO Box 47852
Olympia, Washington 98504-7852
www.doh.wa.gov/crs
tel. 360-236-2944
fax.360-236-2901
Project Info:
CRS# 60260351 Project 21601 76th Ave W
Swedish Edmonds Hospital location: Edmonds, WA 98026-7507
Chapter 246-320 WAC Hospitals
MRI Replacement Local Permit #:
Key People:
Assigned DOH Mina Zarelli
Reviewer: mina.zarelli@doh.wa.gov
Facility Swedish Edmonds Hospital Facility Contact: Same as Administrator
Administrator: Stefan Rehnfeldt
21601 76th Ave W
Edmonds, WA 98026-7507
(425) 640-4211 x.
X.
stefan.rehnfeldt@swedish.org
Architect / Collins Woerman
Local AHJ: City of Edmonds
Engineer: Scott Rice
Leif Bjorback
710 2nd Ave Ste 1400
121 5th Avenue North
Seattle, WA 98104
Edmonds, WA 98020
(206) 245-2100 x.
(425) 771-0220 x.
srice@collinswoerman.com
Bjorback@ci.edmonds.wa.us
Consultant: N/A
Consultant: N/A
Contact: Maurice Santillanes Contact: N/A
Swedish Edmonds Hospital
X. X.
Maurice. Santillanes@swedish.org
Copies To:
®
Local AHJ: City of Edmonds
❑
DOH Child Birth Center Licensing
®
Architect / Engineer: Collins Woerman
❑
DOH Office of Accommodations & Res. Care Survey
❑
Consultant: N/A
®
DOH Office of Investigations & Inspections
❑
Consultant: N/A
❑
DSHS, Div. Of Alcohol & Substance Abuse
®
Contact: Maurice Santillanes
❑
®
DSHS, Aging & Adult Services Admin.
L&I, Bill Eckroth, Electrical Section
❑
Contact: N/A
L&I, John Harvey, Factory Assembled Structures
®❑
CRS File
Page 1 of 5 Plan Review Comments for Project #60260351
r acuityyata uertincate:
Facility Name: Swedish Edmonds Hospital
Site Address: 21601 76th Ave W
Edmonds, WA 98026-7507
Estimated Date of Occupancy: currently occupied
Licensee UBI#: 602997735
Critical Access Facility: ❑ Yes ® No
Occupancy I-2
Construction
1-A
Applicable Code:
2000 NFPA 101
Group:
Type:
2009 IBC
2010 FGI Guidelines
Qn
W
Number of Current:
Added:
Removed:
Total:
Beds:
Automatic Fire Sprinkler System: ® Yes
❑ No
Type
Automatic Fire Alarm System:
® Yes
❑ No
Compartmentation req'd:
❑Yes
®No
Smoke Control System Provided: ❑ Yes ❑No
Gz+
Special Delayed Egress Control:
❑ Yes
®No
Location:
Certificate of Need Required:
❑ Yes
®No
CON Approval Granted:
❑ Yes ❑No
CON Number:
Number of units: Private occupancy: Two person occupancy:
Based on size of rooms used for sleeping Residents
OBased on size of common rooms Residents
H H Maximum allowable licensable beds:
Z�
W d Qualifies for Assisted Living Funding Program ❑ Yes ❑No Number of qualifying units:
Replacement of existing MRI equipment. This project includes removal of existing finishes, new shielding, new
finishes and casework.
The data above is based on the information presented to CRS. Any change in the facility or facility program that
causes the above information to be incorrect is subject to review by CRS. Approval for construction is not
approval for licensure. A copy of the facility data certificate will be sent to the licensing agency.
Page 2 of 5 Plan Review Comments for Project #60260351
Swedish Edmonds Hospital
Chapter 246-320 WAC Hospitals
MRI Replacement
Project Status.
�,,, l 1 1 � l �1� 1 " 1 �° �• (�� 1 r�i 1�a ,. ��, t 1' � o ��� } ...,,1 I � I 1 �' 1 1,1; . l ,,,.
All Comments me1"1I Approved
The construction documents have been reviewed and found acceptable. Construction can begin, subject to
construction permitting from the local building official. The project is not approved for use until the Office
of Investigations and Inspections has been notified by CRS that the project has been completed.
Once the Project Close-out Requirements below have been completed, we will notify DOH Office of
Investigations and Inspections that you have completed the review process and are ready for licensing. Any
revisions to the documents (change orders or addenda) shall be submitted to the department for review.
Additional comments may follow based on documents received and site inspections may be required to
verify compliance.
Please note the following:
The stamped "Authorization to Begin Construction" drawings will be delivered to the Facility
Administrator. These shall be kept available on site for inspection during construction and post
occupancy survey.
® Any changes/deviations (incl. change orders or addenda) from the stamped documents must be
submitted to the Department for review and approval.
® Please include your CRS number on all communications to Construction Review Services.
PROJECT CLOSE-OUT REQUIREMENTS You must notify the department when construction is
complete by completing the following steps:
✓ Verify that you have resolved all of the comments on this form and have submitted any revisions
✓ Complete the Notification of Construction Completed at:
lrtt f0 t rlrr r cr1C1..w�r.11llf d p q r/t ll rink cacanIlllun
✓ Email or fax a copy of the approval from the local building department (final permit approval or
certificate of occupancy); and
✓ Email or fax a floor plan showing the scope of work.
✓ Email: 2'„1cw?awlwtlwawfy Fax: 360-236-2901, Attn: Construction Review
Once your construction project is complete, you may contact the DOH Office of Customer Service (360-236-
4700) for help with adjusting or amending your license to add this project. You can monitor project status at
wrwvwdoh. Via, Yrrwcr•s.
Page 3 of 5 Plan Review Comments for Project # 60260351
Swedish Edmonds Hospital
Chapter 246-320 WAC Hospitals
MRI Replacement
Plan Review Comments:
� b
Q
Preliminary Conference — 11/17/11
Attendees:
Mina Zarelli (mina.zarelli@doh.wa.gov) — Department of Health
Stefan Rehnfeldt — Swedish Edmonds
Maurice Santillanes — Swedish Edmonds
El Provide a copy of the facility's Infection Control Risk Assessment (ICRA) for this
project. The assessment shall identify risks and describe provisions for infection control
and safety of the facility's occupants during this project. The ICRA must be individually
tailored to fit each area of the project and must be signed and dated by the Hospital
Infection Control Manager. The design professional shall incorporate the specific
construction -related requirements of the ICRA into the contract documents, and include
the locations of temporary barriers, anterooms, negative pressure outlets, contractor
access, covered materials transport and debris removal, etc.
WAC 246-320-505(2)(c)(i)(C) & 2010 FGI 1.2-3
Approved 11/23/11— Based on ICRA received 11/23/11
2 El Provide an interim life safety measures plan (ILSM) to ensure the health and safety of all
occupants adjacent to the work area during construction. Indicate the exiting paths to be
used during construction and materials used as temporary construction barriers.
Combustible materials, such as plastic sheeting, that do not meet the requirements of
NFPA 701 shall not be used as barriers. The ILSM must be included in the contract
documents and the contractor must implement these requirements during construction.
WAC 246-320-505(2)(c)(i)(B) & 2009 IFC Chapter 14.
3 0
4 ❑x
Approved 11/23/11— Based on ILSM received 11/23/11
Provide manufacturer plans identifying the 5 gauss line. 2010 FGI 2.2-3.4.4
Approved 2/3/12 — Based on plans received 1/12/12
Verify sprinkler heads will not be blocked by the new equipment or casework. If heads
must be relocated as part of this project, provide a revised plan for review.
Deemed 2/3/12 - Review and approval by the local authority having jurisdiction
(Edmonds Building Department) satisfies this comment.
Page 4 of 5 Plan Review Comments for Project # 60260351
Swedish Edmonds Hospital
Chapter 246-320 WAC Hospitals
MRI Replacement
5 191 Provide final testing report from the manufacturer to verify existing utilities (electrical,
mechanical) are provided and meet the requirements for the new equipment. 2010 FGI
2.2-3.4.4.7
Approved 2/3/12 — Based on testing reports plan received 2/1//12
6 El Provide a functional program for this project if the use of the MRI equipment will change
with the new equipment. Will the MRI equipment be used for image guided biopsies or
procedures? 2010 FGI 1.2-2
Approved 2/3/12 — Based on response received 1/12/12, the function of the space will
not change.
Compliance with the comments above provided by the Department of Health, Construction Review Services, are necessary for this facility to meet
the requirements of the applicable licensing regulations found in the Washington State Administrative Code and associated references. These
comments do not relieve the facilityfrom the responsibility to meet the requirements of any other applicable federal, state or local regulations.
In the event of conflicts between other jurisdictions and these written comments, the most stringent shall apply.
Page 5 of 5 Plan Review Comments for Project # 60260351