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STEVENS HEALTH DEPT APPROVAL LETTER.docx Letter of Transmittal June 28, 2017 Construction Review Services 111 Israel Rd. SE Tumwater, WA 98501 PO Box 47852 Olympia, Washington 98504-7852 Address Plans To (internal use only): Swedish Edmonds www.doh.wa.gov/crs Attn: Facility Administrator tel. 360-236-2944 21601 76th Ave W fax. 360-236-2321 Edmonds, WA 98026-7507 Project Info: CRS# 60574911 Project 21601 76th Ave W location: Edmonds, WA 98026 Swedish Edmonds Chapter 246-320 WAC Hospitals Local Permit #: Linear Accelerator Replacement Key People: Assigned DOH Kevin A. Scarlett, RA Reviewer: kevin.scarlett@doh.wa.gov Facility Swedish Edmonds Facility Contact: Swedish Edmonds Administrator: Jim Yates Jody Elsom 21605 76th Ave W 21605 76th Ave W Edmonds, WA 98026 Edmonds, WA 98026 (206) 386-6000 x. (206) 349-3244 x. jim.yates@swedish.org jody@projectplanningpartners.com Architect / CollinsWoerman Local AHJ: Edmonds, City of Engineer: Scott Rice Leif Bjorback nd 710 2 Ave, Ste 1400 121 5th Ave N. Seattle, WA 98104 Edmonds, WA 98020-3145 (206) 245-2071 x. (425) 771-0220 x. srice@collinswoerman.com bjorback@ci.edmonds.wa.us Consultant: Mac Miller Facility Consultant: Sparling Chris Lee Derek Holdt th PO Box 47983 4100 194 St SW Seattle, WA 98146 Lynnwood, WA 98036 (206) 768-4266 x. (206) 667-0527 x. chris.lee@macmiller.com dholdt@sparling.com Contact: N/A Contact: N/A x. x. Copies To: , City of DOH Child Birth Center Licensing Local AHJ: Edmonds DOH Office of Investigations & Inspections Architect / Engineer: CollinsWoerman L&I Electrical Section Miller Facility Consultant: Mac L&I Factory Assembled Structures Consultant: Sparling /A Contact: N CRS File /A Contact: N Page 1 of 4 Plan Review Comments for Project #60574911 Facility Data Certificate: Facility Name: Swedish Edmonds Licensee UBI#: 602997735 Site Address: 21601 76th Ave W Critical Access Facility: Yes No Edmonds, WA 98026 Estimated Date of Occupancy: 09/25/2015 Occupancy B Construction 2-B Applicable Code: 2000 NFPA 101 Group: Type: 2012 IBC 2010 FGI Guidelines ALL FACILITY TYPES Number of Current: Added: Removed: Total: Beds: Automatic Fire Sprinkler System: Yes No Type 13 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: Replacement of existing linear accelerator with new linear accelerator and replacement of existing casework and finishes. 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 2 of 4 Plan Review Comments for Project # 60574911 Swedish Edmonds Chapter 246-320 WAC Hospitals Linear Accelerator Replacement : Project Status -Authorization to Begin Construction- -At Owner’s Risk- not approvedSubject to construction permitting from the local building This project is for use or licensure. official, construction can begin without delay. Proceeding with construction constitutes facility acknowledgement that it is doing so at its own risk. Initial plan review of the construction documents may or may not have occurred, however construction may begin, subject to construction permitting from the local building official. 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. Please include your CRS number on all communications to Construction Review Services.  You can monitor project status at www.doh.wa.gov/crs. 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.gov/crs. Page 3 of 4 Plan Review Comments for Project # 60574911 Swedish Edmonds Chapter 246-320 WAC Hospitals Linear Accelerator Replacement Plan Review Comments: ID # Not Approved Approved Comment 1  Approved – 06/25/2015 - The DOH/CRS Plans Reviewer has reviewed and approved this project. It appears this project is in compliance with applicable regulations and codes. Provide a copy of any changes made during construction. When the project is complete, you must complete the project closeout process. 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 4 of 4 Plan Review Comments for Project # 60574911