Ste 212.doc
Letter of Transmittal
June 28, 2017
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# 60174486 Project 21616 76th Ave W Ste 212
Swedish Emonds location: Edmonds, WA 98026
Chapter 246-320 WAC Hospitals
Stevens Professional Clinic Local Permit #:
Key People:
Assigned DOH Mina Zarelli
Reviewer: mina.zarelli@doh.wa.gov
Facility Swedish Edmonds Facility Contact: Same as Administrator
Administrator: Stefan Rehnfeldt
th
21601 76 Ave W
Edmonds, WA 98026
(425) 640-4211
srehnfeldt@stevenshospital.org
Architect / Zimmer Gunsul Frasca Architects Building City of Edmonds
Engineer: Kari Thorsen Official: Leif Bjorback
925 4th Ave, Ste 2400 121 5th Ave N
Seattle, WA 98104 Edmonds, WA 98020
(206) 521-3439 (425) 771-0220
kari.thorsen@zgf.com Bjorback@ci.edmonds.wa.us
Sprinkler / N/A Fire Alarm N/A
Contractor: Contractor:
Other: N/A Other: N/A
Copies To:
Local Building Official: City of Edmonds DOH Child Birth Center Licensing
Zimmer Gunsul Frasca
DOH Office of Accommodations & Res. Care Survey
Architect / Engineer:
DOH Office of Investigations & Inspections
Architects
DSHS, , Div. Of Alcohol and Substance Abuse
N/A
Sub-Contractor:
DSHS, , Aging & Adult Services Administration
N/A
Sub-Contractor:
L&I, Bill Eckroth, Electrical Section
Other:
L&I, John Harvey, Factory Assembled Structures
Washington State Patrol, Fire Protection Bureau
CRS File
Page 1 of 7 Plan Review Comments for Project #60174486
Swedish Emonds
Chapter 246-320 WAC
Hospitals
Stevens Professional Clinic
Memo:
- Authorized to Begin Construction –
- Comments Not Approved –
not approved
This project is for use or licensure. The construction documents have been reviewed and
construction can begin, subject to construction permitting from 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 Notification of Construction Completed at:
http://static.doh.wa.gov/hsqa/fsl/CRS/pink_card.htm
Email or fax the assigned reviewer (see page 1) a copy of the approval from the local building
department (final permit approval or certificate of occupancy); and
Email or fax the assigned reviewer a floor plan showing the scope of work.
You will be recommended to Licensing, when you have completed these items.
You can monitor project status at www.doh.wa.gov/crs.
Page 2 of 7 Plan Review Comments for Project # 60174486
Facility Data Certificate:
Facility Name: Swedish Emonds Licensee UBI#: 312003974
Site Address: 21616 76th Ave W Ste 212 Critical Access Facility: Yes No
Edmonds, WA 98026
Estimated Date of Occupancy: October 2010
Occupancy B Construction 5-A Applicable Code: 2000 NFPA 101
Group: Type: 2009 IBC
2006 FGI Guidelines
ALL FACILITY TYPES
Number of Current: N/A 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
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:
RESIDENTIAL CARE
FACILITIES ONLY
Based on size of rooms used for sleeping Residents
Based on size of common rooms Residents
Maximum allowable licensable beds:
Qualifies for Assisted Living Funding Program Yes No Number of qualifying units:
Renovations of an existing clinic to be added under the hospital license as a multi-disciplinary clinic in the space.
NOTES
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 3 of 7 Plan Review Comments for Project # 60174486
Swedish Emonds
Chapter 246-320 WAC Hospitals
Stevens Professional Clinic
Comments
Preliminary
Comment ID #
Preliminary Conference – 7/8/10
Attendees:
Mina Zarelli – Department of Health
Steve Pennington – Department of Health
Stefan Rehnfeldt – Stevens Hospital
Kari Thorsen – ZGF Architects
The preceding are preliminary comments provided as information and for use preparing the
construction documents. These preliminary comments may be revised during subsequent
submissions/conferences. Additional preliminary comments may be made during subsequent
submissions.
Items Received:
T1 Existing building has unprotected exit stair enclosures. Stairs will need to be enclosed per NFPA
or submit alternate means of compliance information (FSES – Fire safety evaluation system)
T2 Provide complete fire sprinkler and alarm drawings (if available).
T3 Describe in functional program the population type (age, any assistance needs). Are any patients
on gurneys or wheelchairs? Consider wider door in new ADA exam/treatment space.
T4 Describe in functional program the most invasive types of procedures performed within the area
of this project. Identify the specific location and procedures that require the most equipment,
require the most personnel, and are the most invasive. Refer to the definition of “invasive
procedure” in the 2006 FGI Glossary.
If invasive procedures are performed, the Plumbing and HVAC chapter 3.1-7.1 and 7.2 apply
requiring ducted returns, secondary filters and required air pressure relationships.
T5 Describe in functional program or show on plans any unique equipment (fixed or mobile) that
would occupy floor space.
Page 4 of 7 Plan Review Comments for Project # 60174486
Comment ID #
T6 Describe in functional program how the Lab will be used.
T7 Describe in functional program the general types of medications to be stored and identify
locations on plans.
T8 Describe in functional program how medical records are secured.
T9 Existing exam rooms are less than 80 net square feet. Fully dimension rooms and clearances at
exam tables on the plans. Evaluate use and fully describe in the functional program.
T10 Provide housekeeping room and soiled holding. Soiled linen holding in a closed cabinet may be
located within the Lab space depending on amount generated, or if there are no infection control
issues.
T11 Identify locations of portable fire extinguishers, exit signs, emergency lighting on the plans.
T12 Provide life safety plans showing all rated partitions and general life safety information within
and near the planned scope of work. General life safety information includes locations of exits,
horizontal exits, travel distances and exit widths. Plans should also identify locations and extents
of occupancies, smoke compartments and suites.
T13 New toilet rooms – door swing out and breakaway hardware
T14 Curtains for patient privacy
T15 Handwashing sinks are not required at MA Station, however DOH highly recommends Alcohol
Based Hand Rubs in these areas.
Page 5 of 7 Plan Review Comments for Project # 60174486
ID #
Not Approved
Approved
Comment
The following plan review comments:
Note: A Fire Safety Evaluation Worksheet for Business Occupancies submitted by Kari
Thorsen, ZGF on 8/9/10 has been approved for this project. This worksheet has
determined that the level of fire safety provided in this building is at least equivalent to
the life safety requirements of NFPA 101, Life Safety Code.
The facility was found to be deficient in the requirements of NFPA 101 Sections
38.2.4.2, 7.2.2.5 and 8.2.5.5 because of conditions relating to the Exit Stairs. This
worksheet relieves the facility from complying with these requirements.
1 Two complete plans and specifications for the fire alarm system installation or
prior
modification shall be submitted for review and approval 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
Incomplete plans and specifications will be returned without review
materials. . 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
Not approved 8/26/10 based on 1993 fire alarm plans received 8/9/10. Section 907.1,
International Fire Code rb
Re-submit fire alarm drawings with labeled rooms and updated floor plans or
submit an 11x17 floor plan attached to the drawings. Include any documents
showing revisions to the fire alarm system due to this remodel and the most recent
test and inspection reports.
2 Provide building permit # from the local building department. Construction may not
begin until the local jurisdictions have issued a building permit or given approval to
occupy. WAC 246-320-505(3)(d)
Page 6 of 7 Plan Review Comments for Project # 60174486
3 Provide two complete sets of plumbing, and electrical plans. Plans shall be coordinated
between disciplines and must be stamped and signed by a Washington State licensed
architect or engineer complying with all applicable codes, regulations, and requirements.
WAC 246-320-505
4 Provide complete HVAC system plans showing room names and numbers, location and
sizing of all HVAC system components including air handling unit(s), ductwork, grilles
and diffusers, filter schedules, room pressurization and air change schedules, outside air
quantities, thermostat type & locations, air quantities delivered to each room, fire, smoke
and fire/smoke damper locations, and other information required to insure the system
complies with all requirements of the 2006 FGI Chapter 3.1-7.2.
5 Receptacles in areas of the facility accessible to children shall be of the tamper-resistant
type.
6 Identify location of toilet for waiting room/public use described in the functional
program. Waiting room and staff may share the same toilet room. Toilet 204 is
described as staff only per the functional program. 2006 FGI 3.1-4.1.4
7 Sink in Lab/Soiled Holding 215 is single basin and used for instrument cleaning per the
functional program. A handwashing sink is required for Lab use. Provide double basin
or separate sink for handwashing. 2006 FGI 3.1-2.3.2
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 facility from 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 7 of 7 Plan Review Comments for Project # 60174486