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Memorandum
Date
To
From
Project
Project
Subject
Vt
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June 8, 2015
Leif Bjorback, wilding Official
Kent Gregory
Edmonds Center for Outpatient Surgery
13065
Plan check 2014-0117 response to comments
In response to Plan Review Comments dated March 11, 2014 please see the following responses.
1. Please update references on sheet A0.10 to the current use of the surgical center group 1-1.2 to B ambulatory
care facility. Please see review comments from John Westfall which are similar to what this Building Division
review is concerned within regards to the ACF requirements. IBC 304.1 and 422.
I believe that there are 2 ways to interpret the application of the new IDC requirements over the previous, more
restrictive code under which the facility was originally build. 1) The existing 2 hour occupancy separation wall
that original separated the 11.2 and D occupancies may still be recognized as an occupancy separation that
divides 6 ambulatory care facility from P. In this view the D occupancy to the east of the 2 hour separation
wall would have only one care recipient incapable of self-preservation, falling below the threshold of 4 defined
in 422.2. This area would then not be required to comply with 422.1 — 422.7. The existing occupancy to the
west of the separation wall meets the requirements of 422.1 — 422.7. 2) The other way to view this
requirement would be assume that the 2 hour separation wall is no longer required, and is therefore ignored.
In this case the whole surgery center would still comply with the requirements of 422 at follows: 422.2: the
surgery center is separated from adjacent areas with a fire partition installed per 708. 422.3: the surgery
center is subdivided by a smoke compartment designated by the note "1 hour wall'. 422.4: each compartment
has adequate space to provide 30 nsf of refuge space for per occupant. 422.5: each compartment has
independent egress. 422.6: An automatic sprinkler system is provided throughout. And 422.7: a fire alarm
system is provided.
2, On sheet M3.01 please add fire smoke dampers on 2 existing ducts that penetrate the 2 hour wall or OR #1 on
gridline 4, or explain why these may not be required by code.
Please see revised Mechanical drawings. Please also see attached Rice Group letter dated 6/5/15 addressed
to DOH further responding to DOH requirements.
Created on 62/2015 4:26 PM Response 6O CIty Comments . page I of 2
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3. Provide mcopy of the Department of Health review letter for the project. Any DOH requirements identified in
the letter must bnincorporated /nthe building permit plan set for city review prior boissuance of the permit.
Please see attached DOH review letter dated June 8, 2015 giving authorization to commence construction
(reference page 3).
In response to John Westfall's 2/24/14 memo, please see the following responses:
1. Please see response ho#1 above.
2. The proposed scope of work will have NO CHANGE to the code analysis, please see response to #1 on page
one. The only recognized change is the code designation change from 11.2 to B -ASF in the area adjacent to the
proposed work area. There ianodesignation change etthe proposed area ofwork. The code change
designation ianoted onthe drawings. The existing Medical Gas storage area iointhe basement ofthe building.
There iaNOCHANGE huthe medical gas storage area. Changes hmthe Medical Gas distribution system iolimited
bothe work area and noted onM2.UO.
3. See revisions on AO.1 0 Code Analysis Sheet that indicates location of Medical Gas storage at the Basement
level. There are no proposed changes to medical gas types, storage quantities, or storage locations. (2)
additional Medical Vacuum outlets are added atthe work area.
Created on 6�2/20 t 5 4:26 PNI - Response tOCity Comments - page 2 of2
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110EGroup,
Consulting Engineers
June 5, 2015
Steve Pennington
Washington State Department of Health
111 Israel Rd. SE
Tumwater, WA 98501
Reference: CRS# 60416195
Stevens Pavillion Suite 140
7320 216t" St. SW
Dear Mr. Pennington:
The following is in response to your correction comments dated June 5, 2015. Please
find below our itemized responses to each respective comment and department. Each
item addressed was clouded on the respective plan sheet.
5) The code required OSA ACH was incorrect. The number has been changed
to 3 ACH of OSA. The system is still supplying 17.2 ACH of OSA.
6) Fire smoke dampers have been added to the existing ducts that penetrate
the 2 hour wall of OR#1 at gridline 4.
8) The smoke venting process has been added to page 113.01. When the local
smoke detector is activated, motorized dampers in the low wall returns
close and the motorized damper in the ceiling grille opens. The smoke is
then evacuated from the ceiling.
I trust this is satisfactory for you to complete your individual reviews and sign off.
Please notify us immediately if you need additional information.
Sincerely,
Paul Goto
RICE Group INC., E.I.T.
Letter of Transmittal
June 8, 2015
Washington State Department of
Hualth
Construction Review Services
I 1 I Israel Rd. SE
Tumwater, WA 98501
PO Box 47852
Olympia, Washington 98504-7852
www.doh.wa.gov/crs
tel. 360-236-2944
fax. 360-236-2321
Project Info:
Local AHJ: City of Edmonds
❑
CRS# 60416195
Project
7320 216th St SW Ste 140
Edmonds Center for Outpatient Surgery
location:
Edmonds, WA 98026-8028
WAC 246-330 Ambulatory Surgery Facilities
DSHS, Div. Of Alcohol & Substance Abuse
Initial Review ASC OR Expansion
Local Permit #:
❑
Key People:
❑
Contact: N/A
Assigned DOH Steve Pennington / Matthew Campbell
L&I, Bill Eckroth, Electrical Section
❑
Reviewer: steve.pennington@doh.wa.gov
❑
L&I, John Harvey, Factory Assembled Structures
Facility Edmonds Center for Outpatient Surgery
Facility Contact:
Same as Administrator
Administrator: D. Chris Douglas
®
CRS File
7320 216th St SW
Edmonds, WA 98026
(425) 673-3901 x.
X.
d.douglas@proliancesurgeons.com
Architect / TGB Architects
Local AHJ:
City of Edmonds
Engineer: Dave Letrondo, AIA
Leif Bjorback
21911 761 Ave W
(425) 771-0220
Edmonds, WA 98026
bjorback@ci.edmonds.wa.us
(425) 778-1530 x.
X.
Consultant: Rice Group Inc
Consultant:
AWA Electrical Consultants, Inc
Paul Goto
Sally Sanders
20201 Cedar Valley Rd Ste 120
19015 36th Ave W Ste E
Lynnwood, WA 98036
Lynnwood, WA 98036
(425) 774-3829 x.
(425) 775-1799 x.
paulg@ricegroup.com
sally@awaelec.com
Contact: N/A
Contact:
N/A
X.
Copies To:
X.
®
Local AHJ: City of Edmonds
❑
DOH Child Birth Center Licensing
®
Architect / Engineer: TGB Architects
a
DOH Office of Investigations & Inspections
®
Consultant: Rice Group Inc
DSHS, Div. Of Alcohol & Substance Abuse
®
Consultant: AWA Electrical Consultants, Inc
❑
DSHS, Aging & Adult Services Admin.
❑
Contact: N/A
❑
L&I, Bill Eckroth, Electrical Section
❑
Contact: N/A
❑
L&I, John Harvey, Factory Assembled Structures
❑
®
CRS File
Page 1 of 9 Plan Review Comments for Project #60416195
r aclhty data c;ertnicate:
Facility Name: Edmonds Center for Outpatient Surgery
Site Address: 7320 216th St SW Ste 140
Edmonds, WA 98026-8028
Estimated Date of Occupancy: Currently Occupied
Licensee UBI#: 601484763
Critical Access Facility: ❑ Yes ® No
This project infills an existing room to convert it to a fourth class "C" operating room and evaulates the existing
service for the additonal loads a fourth room adds to those services. General anethesia is used and procedures
include, ortho, ent, general, gyn, but no endoscopy. Facility bills medicare.
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 9 Plan Review Comments for Project #60416195
Occupancy B
Construction
2-A
U
O
Applicable Code:
2000 NFPA 101
Group:
Type:
W U
Qualifies for Assisted Living Funding Program ❑ Yes ❑No Number of qualifying units:
W�U
2006 FGI Guidelines
CA
pW
Number of Current:
N/A
Added:
Removed:
Total:
HBeds:
>,
Automatic Fire Sprinkler System:
® Yes
❑ No
Type 13
aAutomatic
Fire Alarm System:
®Yes
❑ No
00
Compartmentation req'd:
®Yes
❑No
Smoke Control System Provided:
❑ Yes ®No
Wo
aSpecial
Delayed Egress Control:
❑ Yes
®No
Location:
d
Certificate of Need Required:
® Yes
❑No
CON Approval Granted:
❑ Yes ®No
CON Number:
This project infills an existing room to convert it to a fourth class "C" operating room and evaulates the existing
service for the additonal loads a fourth room adds to those services. General anethesia is used and procedures
include, ortho, ent, general, gyn, but no endoscopy. Facility bills medicare.
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 9 Plan Review Comments for Project #60416195
Number of units: Private occupancy: Two person occupancy:
aBased
on size of rooms used for sleeping Residents
U
O
Based on size of common rooms Residents
FH
Maximum allowable licensable beds:
W U
Qualifies for Assisted Living Funding Program ❑ Yes ❑No Number of qualifying units:
W�U
This project infills an existing room to convert it to a fourth class "C" operating room and evaulates the existing
service for the additonal loads a fourth room adds to those services. General anethesia is used and procedures
include, ortho, ent, general, gyn, but no endoscopy. Facility bills medicare.
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 9 Plan Review Comments for Project #60416195
Edmonds Center for Outpatient Surgery
WAC 246-330 Ambulatory Surgery Facilities
Initial Review ASC OR Expansion
Project Status:
- Authorized to Begin Construction —
This project is not approved for use or licensure. The construction documents have been reviewed and construction
can begin, subject to construction pertnittingfrom the local building official. This project will not be approved until
the comments labeled as "not approved" have been resolved by providing a written response to each of the
comments. When referencing drawings or attached materials, provide sheet; or page #, revision # and date as
applicable. Additional comments may follow based on design team response 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 approved documents must be submitted to
the Department for review and approval.
■ Beginning construction prior to resolving the attached comments will constitute facility acknowledgement that
you are proceeding at your own risk.
® 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 Online Notification of Construction Completed at:
httn://www.doh.`va.gov/NotittcationofCom letion.aspx
✓ 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: fslcrs@doh.wa.gov Fax: 360-236-2321, Attn: Construction Review
Once your construction project is complete, you may contact the DOH Office of Customer Service for help
with adjusting or amending your license to add this project. Their telephone number is 360-236-4700.
You can monitor project status at www.doh.wa.g_ov/crs.
Page 3 of 9 Plan Review Comments for Project # 60416195
Edmonds Center for Outpatient Surgery
WAC 246-330 Ambulatory Surgery Facilities
Initial Review ASC OR Expansion
Preliminary Comments
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Preliminary Conference —November 711, 2013
Attendees:
Steve Pennington (steve.pennini!tonndoh.wa.gov) - Department of Health
Kent Gregory - TGB Architects
Chris Douglas - Edmonds Surgery
Jean Ann Mulcahy - Edmonds Surgery
The preceding are preliminary notes provided as information and for use preparing the
construction documents. These preliminary notes may be revised during subsequent
submissions/conferences. Additional preliminary comments may be made during
subsequent submissions.
Items Received: Initial sketch
Tl General:
➢ Contact Certificate of Need to review the implications of adding additional surgeons
with the changes in this practice. Contact Karen Nidermayer at (360) 236-2957.
➢ Provide an infection control risk assessment.
T2 Life Safety:
➢ Provide as part of the project submittal up to date plans showing all rated walls, smoke
barriers and required exiting.
➢ A number of exit access pathway lights, battery packs were not operational and need to
be replaced as a maintenance item and not part of this project.
➢ Exiting after walk through and designation of those exit paths is acceptable.
T3 Electrical:
➢ The essential electrical system will need to be evaluated for sizing of the generator,
having all the required loads on it, providing the required branches for life safety,
critical and equipment.
T4 Medical records:
➢ The medical records are not electronic and are stored in a locked room in the front
business area and no project work is needed in this location.
T5 Reception/waiting:
➢ No project related work is needed in these areas.
Page 4 of 9 Plan Review Comments for Project # 60416195
Edmonds Center for Outpatient Surgery
WAC 246-330 Ambulatory Surgery Facilities
Initial Review ASC OR Expansion
Q
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T6 Recovery:
➢ The required number of PACU, level two recovery spaces is acceptable for a four
operating room facility.
➢ Floor will need to be evaluated for the ability to clean and not harbor bacteria or mold,
with special emphasis in the PACU area as part of project.
T7 Janitors closet SC -124:
➢ The janitor's closet is required to be negatively pressurized to adjacent spaces and this
room tested neutral as there was no exhaust located in the ceiling. This will be a
project requirement to modify this condition.
T8 Recovery Nurses stations:
➢ Medications were secured as required and other than maintenance related items, No
project work is expected in this area.
T9 Sectioning room # SC -150:
➢ This room was negatively pressurized as required and no work is expected in this room
as part of the project.
T10 Medical gas manifold room and vacuum pump room.
➢ Both of these rooms meet the requirements for a level one medical gas system and no
project related work is expected in these rooms. The oxygen manifold is 8 cylinders
each, for in use and reserve.
T11 Main electrical room:
➢ Many combustible items are stored in this room in front of the electrical panels
blocking working clearances and should not be stored there. This is a maintenance
item/fire hazard that needs to be quickly addressed and not part of the project
T12 Sterile storage area SC -136
➢ The room tested properly for a positive pressure relationship
➢ These areas have a plenum return system that is causing dust problems and must be
changed to support a constant positive pressure relationship and to solve the dust
problem. Contact Steve Pennington to discuss solutions that we have used at other
facilities. This will be a project required upgrade.
T13 Soiled holding SC -133:
➢ Room tested for a negative pressure relationship and there is no expected project
related work in this room.
Page 5 of 9 Plan Review Comments for Project # 60416195
Edmonds Center for Outpatient Surgery
WAC 246-330 Ambulatory Surgery Facilities
Initial Review ASC OR Expansion
0
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T14 Staff changing rooms:
➢ Address scrubs being stored out in the open by adding doors to these cabinets to
prevent cross contamination or another solution.
T15 Clean processing and storage SC -140:
➢ This space tested negatively pressurized to adjacent corridors and is required to be
positively pressurized. Will be part of project, but should be rebalanced as soon as
possible before project to provide the correct pressure relationship.
➢ Leveler blinds on windows need to be removed as they are not cleanable as part of
project.
➢ Overhead lights do not have lenses in them that are not cleanable and can allow dust to
come into space from the plenum. This will be part of project to correct.
➢ Provide a means to monitor humidity with a top limit of 70% RE.
T16 Decontamination room:
➢ This room met the negative pressure relationship requirements and other than some
maintenance/operational items, there are no project related work expected.
T17 New Operating room:
➢ Provide a hard lid ceiling in this room.
➢ Provide non -aspirating supply air diffusers creating the sterile field around the table.
➢ Provide task lighting including at least one of which has a battery back up feature.
➢ HVAC needs to provide 15 ACH minimum or which three are from outdoors.
➢ Provide smoke ventilation for this room.
➢ Provide 2 oxygen outlets and three suction outlets for a class "C" operating room.
➢ Review door hardware for the push/ pull feature.
➢ Caulk all gaps including around casework, top of "J" molding around light fixtures and
air grill in new ceiling.
➢ Provide a scrub sink outside of the room and adjacent to the entry door.
➢ Verify or provide a minimum of a Mery 14 final air filter.
➢ Provide means to manage humidity in this room.
➢ Provide clean room sprinkler heads in this room.
T18 Housekeeping closet:
➢ Provide a dedicated housekeeping closet for the surgery area.
T19 Corridor # SC -149:
➢ The ceiling in this area and corridor SC -129 will be required to have a washable
ceiling tile. Part of project to correct.
Page 6 of 9 Plan Review Comments for Project # 60416195
Edmonds Center for Outpatient Surgery
WAC 246-330 Ambulatory Surgery Facilities
Initial Review ASC OR Expansion
➢ The lights in both the above corridors do not have lenses and are therefore not
cleanable and subject to no protection below from tube breakage. Part of project to
correct.
T20 Existing three operating rooms:
➢ Not part of project.
T21 Equipment room SC -127:
➢ Is being used for clean storage in a covered cart.
➢ This room has no ventilation, so no open clean storage can be done here.
➢ Maybe a good location for the dedicated housekeeping.
T22 Existing patient restrooms:
➢ No project work expected.
T23 Medicare one hour wall:
➢ Design/contractor should verify that the one hour fire barrier has complete fire
stopping of all penetrations.
Page 7 of 9 Plan Review Comments for Project # 60416195
Edmonds Center for Outpatient Surgery
WAC 246-330 Ambulatory Surgery Facilities
Initial Review ASC OR Expansion
Plan Review Comments:
Q
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1
l El Two complete plans and specifications for the fire alarm system installation or
modification shall be submitted for review and approval prior to system installation.
The department reserves the right to defer plan review and inspections to the local
authority having jurisdiction (AHJ). Plans and specifications shall include, but not be
limited to, a floor plan; location of all alarm -initiating and alarm -signaling devices;
alarm -control and trouble -signaling equipment; annunciation; power connection; battery
calculations; conductor type and sizes; voltage drop calculations; name, address, and
phone number of the agency receiving off -premises transmission of alarm; and the
manufacturer, model numbers, and listing information for all equipment, devices, and
materials. Incomplete plans and specifications will be returned without review. Plans
and specifications may be submitted separately from construction documents during the
construction of the project. For small renovation projects in which devices are only to be
relocated or very few devices are to be added, provide two plans that shows the
relocation of devices which may be submitted for review in lieu of the above
requirements. This information can be included on the electrical or architectural plans.
Verify with Department staff to determine if the scope of your project meets this criteria.
Section 907. 1, International Fire Code
Recommend that fire alarm strobe/horn not be installed inside of the new operating
room as a safety concerns during surgery.
2 El Two sets of sprinkler system working plans shall be submitted for review and approval
before any equipment is installed or remodeled. The department reserves the right to
defer plan review and inspections to the local authority having jurisdiction (AHJ).
Deviation from approved plans will require permission. Plans and specifications,
including hydraulic calculations, that are incomplete or are not stamped by a Washington
State Licensed Fire Sprinkler Contractor, will be returned without review. Plans and
specifications may be submitted separately from construction documents during the
construction of the project. For small renovation projects in which heads are only to be
relocated, a plan that shows the relocation of devices can be submitted for review in lieu
of the above requirements. Section 903. 1, International Fire Code
Provide clean room concealed fire sprinkler heads in the new operating room to
meet the monolithic ceiling requirements of 2006 FGI 3.7-5.2.2.2(2)
(2) Restricted areas. Ceilings in restricted areas such as operating rooms shall be monolithic, scrubbable,
and capable of withstanding chemicals. Cracks or perforations in these ceilings are not allowed.
Page 8 of 9 Plan Review Comments for Project # 60416195
Edmonds Center for Outpatient Surgery
WAC 246-330 Ambulatory Surgery Facilities
Initial Review ASC OR Expansion
❑x Provide a structural engineer stamp on the design of the overhead surgery light support
as seen in section # 7 of sheet A0.10 per WAC 246-330-510 (1)
4 Mx Provide a dedicated housekeeping closet for the surgery area per 2006 FGI 3.7-2.5.8
2.5.8 Housekeeping Room
A housekeeping room containing, a floor receptor or service sink and storage space for housekeeping
supplies and equipment shall be provided exclusively for the surgical suite.
❑x Room pressurization schedule on sheet M1.01 shows the operating room to only have 2
air exchanges from the outside and it is required to have 3 outside air exchanges per
Table 2.1-2 of the 2006 FGI
6 El Provide afire damper in the 18"X12" return air duct and the 10" round duct where they
penetrate the two hour fire barrier at grid line 4/H per NFPA 90A 3-3.1.1
(reference sheet M3.00)
7 ❑x Where are the other life safety loads such as exit signs, exit access pathway lighting,
nurse call systems located if not on the life safety panel. WAC 246-330-510
0 How is smoke venting provided in the new operating room per NFPA 99 Chapter 5-4.1.2
5-4.1.2 Supply and exhaust systems for windowless anesthetizing locations shall be arranged to automatically vent
smoke and products of combustion.
9 0 Provide the paint specification to be used on the walls and ceiling of the new operating
room that supports the scrubbing and resistance to chemical use. WAC 246-330-510
10 ❑x A final inspection is required approximately one week prior to final building permit
approval. Contact Steve Pennington at 360-236-2944 or by e-mail at
steve.pennington(a�doh.wa.gov
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 9 of 9 Plan Review Comments for Project # 60416195