Press Alt + R to read the document text or Alt + P to download or print.

No preview available

The URL can be used to link to this page

Home My WebLink AboutBLD08-218PERMIT # BLD&5 - 21 ?) SCOPE OF WORK: CITY OF PORT TOWNSEND PERMIT ACTIVITY LOG P'111 DATE RECEIVED—_11(3 I 2 . . ...... . ........ . . . ............................. ......... . . . . . --- .............. DATE . ACTION INITIALS . . ... ............... . . . .......... ENTERED INTO CHET . .......... ............................... ... . ............... ................... CHECKED FOR COMPLETENESS ...................... . . . . .... . ................... . . .......... . . . T............ 3 . ....... . OMNI" . . ................ . . ............. .... . ............. . . ................ ...... q, _t)jUp . ........... ... . . ............. ....... ...... .. . ....... L 12,N)_�_ ................ P ................ . . n A, Q0 ..... ........... . . . . ......... 441 be IY4- [A G I V L A?X - A.. : . ............. A V-4- CK�� ............... ....... . ... .. . ....... . ....... . . . ......... . .. . ........ ... . ........ . .............. TFU U70 0 C -7 Tum A . ...... . ... ...... . ............ ........... ........... . ... . ....... . . .... . ....................... . . . . . . .... . . . . . ........... - Z�nin —k:"........ . ............. ........ — - ----- .......... ......... Setbacks 0 K? - - r . ................. ........................... . ........... ... ........... Lot Size: . ........... . ......... Building -_§!z-... e`:____-_----- . .. ............. Lot Coverage: . . . . . ......... FAR OK? --- . . . . ................................... Height OK? Parking OK? Critical Area? . . . .......... Demo? . ... ...... . ..... . ................... -.Historic Rev? Notice to Title? -Lots of Record?- . ......... ?ORT to BUILDING : PERMIT City of Port Townsend Development Services Department 250 Madison Street, Suite 3, Port Townsend, WA 98368 (360)379-5095 Project Information Permit # BLD08-218 Permit Type Commercial Miscellaneous Project Name Install Patient Lifts (31 rooms with Site Address 834 SHERIDAN STREET Parcel # tracks, 6 lifts remain in the rooms & 25 portables) Project Description 948321101 Install Patient Lifts (31 rooms with tracks, 6 lifts remain in the rooms & 25 portables) Names Associated with this Project License Type Name Contact Phone # Type License # Exp Date Applicant Jefferson Co Pub] Hosp Dist #2 Owner Jefferson Co Publ Hosp Dist #2 Contractor Me Contracting O CITY 7980 12/31/2008 Contractor Me Contracting O - STATE MCCONC*931: 07/09/2009 Fee Information Project Details Project Valuation $23,000.00 Entered Bid Valuation 23,000 DOLI Building Permit Fee 363.25 Units: Heat Type: Plan Review Fee 236.11 Bedrooms: Construction Type;, State Building Code Council Fee 4.50 Bathroomso Occupancy Type: Technology Fee for Building Permit 7.27 Record Retention Fee for Building 10.00 Permit Total Fees $ 621.13 Call 385-2294 by 3:00pm for next day inspection. Permits expire 180 days from issuance if work is not commenced, or if work is suspended for a period of 180 days. Work is verified by obtaining a valid inspection. The granting of this permit shall not be consini t"as� approval to violate any provisions of the PTMC or other laws or regulations. I certify that the information provided as a ltpo of the r ph ition for this permit is true and accurate to the best of my knowledge. 1 further certify that I am 11t , wner of the pi-oltet ty W atu ihori' ed ages of the owner. Print Nane"'`� Date Issued: 11/10/2008 Issued By: SFOSTER Signature l,) I(e ) Date Expires: 05/09/2009 t Services 260Madisnn Street, Suite Port Townsend VVA083G8 Phone:3GO-370'5DS6 Fax: 380'344-4619 www.cityofpt.us Commercial Building Permit Application Project Address & Zoning District: Legal Description (or Tax ft Office Use Only Additiom Applications accepted by mail must include a check for initial plan review fee of $150 See the "Commercial Building Permit Application Checklist" for details on plan submittal requirements. Property QWnp�; Address - Phone:—, rs State License #: Exp: City Business License Lender Information: Lender information must be provided for projects over $5,000 in valuation per RCW 19.27.095. Project Valuation. $ 1 Construction Occupancy Rating Building |nfonnsUmn (square faet): 1~f|oor_4,��__. Rentronmo:__� 3rd floor L Storage: nd New El Add Change of Use El Total Lot Covera§#IB'Ul Square feet:10, impervious Surface: Square feet: I hereby certify that the information provided is correct, that | am either the ownerorauthorized toact unbehalf ofthe owner and that all activftiF� associated with tbis, permit will be in accordance with State Laws and the Port Townsend Municipal Code. Print Name: Signature: Omta� / ~~ COMMERCIAL BUILDING PERMIT APPLICATION CHECKLIST This checklist is for new construction, additions, and remodels. The purpose is to show what you intend to build, where it will be located on the lot, and how it will be constructed. Commercial building permit application. ► Non -Residential Energy Code forms: -3:� Lighting * Mechanical * Envelope Three (3) sets of plans with North arrow and scaled, no smaller than '/4" = 1 foot: I Title Page/Cover Sheet: 1. Project identification 2. Project address, legal description, location map, tax parcel number(s) 3. All design professionals identified including addresses and phone numbers 4. Name, address, and phone number of person responsible for project coordination 5. Design criteria, including occupancy group, construction type, allowed floor area vs. proposed, occupant loads, height and number of stories, deferred submittals, etc. 6. Designate compliance with all applicable codes I A site plan showing: 1. Legal description and parcel number (or tax number), 2. Property lines and dimensions 3. Setbacks from all sides of the proposed structure to the property lines in accordance with a pinned boundary line survey 4. On -site parking and driveway with dimensions 5. Street names and any easements or vacations 6. Location and diameter of existing trees 7. Utility lines 8. If applicable, existing or proposed septic system location 9. Delineated critical areas boundaries and buffers Foundation plan: 1. Footings and foundation walls 2. Post and beam sizes and spans 3. Floor joist size and layout 4. Holdowns 5. Foundation venting ► Floor plan: 1. Room use and dimensions 2. Braced wall panel locations 3. Smoke detector locations 4. Attic access 5. Plumbing and mechanical fixtures 6. Occupancy separation between dwelling and garage (if applicable) 7. Window, skylight, and door locations, including escape windows and safety glazing b Wall section: 1. Footing size, reinforcement, depth below grade 2. Foundation wall, height, width, reinforcement, anchor bolts, and washers 3. Floor joist size and spacing 4. Wall stud size and spacing 5. Header size and spans 6. Wall sheathing, weather resistant barrier, and siding material 7. Sheet rock and insulation 8. Rafters, ceiling joists, trusses, with blocking and positive connections 9. Ceiling height 10. Roof sheathing, roofing material, roof pitch, attic ventilation Exterior elevations (all four) with existing slope of the land in relation to all proposed structures I If architecturally designed, one set of plans must have an original signature I If engineered, one set of plans must have one original signature I For new dwelling construction, Street & Utility or Minor Improvement application aFK;S Structural Solutions Seattle 811 First Avenue, Suite 620 • Seattle, WA 98104 • tel: 206.292.5076 %conla 950 Pacific Avenue, Suite 1100 • Tacoma, WA 98402 • tel: 253.383.2797 r.. _ a , ...a .... NPNW. PCs • al I LIC I wril.coil) 5TRUCTURAL CALCULATION5 FOR JEFFER50N GENERAL H05PITAL CEILING PATIENT LIFT OT 5CAN ROOM AND ROOM5 501 TO 351 PORT TONN5END, lNA5H INGTON PREPARED SY P05 5TRUCTURAL 5OLUTION5 2917 OCTOBER 15, 2005 05-464 SCU PRIVATE ROOM PLAN Scale andlor dimensions are approximate and are to be used as a guide only. Optimum track and bracket placement to be determined at time of Installellon. Brackets nol shown on drawing. This drawing and the Information contained hereln Is the property of Angel Accessibility Solutions Ltd. and Is not to be copled or re -Issued. 11A E L. 1 ACCESSIBILITY SOLUTIONS 2508 Bridge Street, Victoria, British Columbia CANADA V8T 51-13 T (250)38M405 F (250)383.7099 Toll Free 1-800-977-0721 E Info@angelsolu8ons.com www. a ng els olu llons.corn JEFFERSON HEALTH CENTER Port Townsend, Washington rla I Rev. Drawn By Scale 14/10/08 - VHM 3/8" = V-0" Al 2 I Scale and/or dimensions are approximate and are to be used as a gulde only, Optimum track and bracket placement to be determined at time of Installation. Brackets not shown on drawing, This drawing and the Information contained herein Is the properly of Angel Accessibility Solutlons Ltd. and Is not to be copled or re -Issued. 7ANGEL �1ACCESSIBILITY SOLUTIONS 2508 Bridge Street, Victoria, Brlllsh Columble CANADA VBT 51-13 T (250) 383-0405 F (250) 383.7009 Toll Free 9-800-077-0721 E Infc@angelsolutons.com www, a ngelsolull ons, com JEFFERSON HEALTH CENTER Port Townsend, Washington 14/10/08 I - I VHM I 3/8" = 1r-0" T SCAN M. 0 " H Z w U q w � u C --� 42 k ' a w N> z w p a I 1LL L V- Y w o Z O W Z Z 0 LL J Z J_ w U 0 4 O e 0 N Z O w Z Z 0 {.L .J Z J_ w U M U) w as w Z w U o w u U 2 fh H � Q any � t T w t > _ E Z 0LL , w 00 LL w o dr 0 LO U) w LU W U o LJJ r � u Q M C W t 2 � Z O' LL L- 0 o LL T 0 10 z O F- w z z O F- LL J U z J_ w U z vJ`U`^^ F- U ti U) Project: (TA rL, Job No: NMFCS Subject: .. .. ...... . . .......................... ... ........... . . . .. ............. ..... ..... 91 sew 11--, of Name: Structural Solutions Originating Office: E] Seattle �1110011 Date: !K N �0, 4 ,, 14,1—, - t7(2— CC", CA VA T', cm, V z P, PI Seattle 811 Fi rit Avei i t i c, Su, i re 510 - Se at i le, WA 91H 0 4 - te 1: 206, 292,5076 vv vvw pes -st, r ulctum 11 � Ca Pin Tacoma � 950 Pac i fi c. Ava �.nuq.% Suite 110 U Ta cot i va, WA 911402 - t e 1: 253, 3M,2797 in' SpkfflcatibN Tra,ek . AtumItimlWhIte Paw4cr CbAt W)TU IRS IWAVOC NA) WE WO)W" CMJIMfl) R"RW rs lit i V*"y 0 lVII WAYLY41Y QfH SA1,z Lru, j) r, to,ejI %(I tic COKU (Xl W,- to 00—T6 NAM� AAA , , 1417 IYY 41' (W k*34'4A MWAIN 0,11114SIX71-1, (,c� et EXIfd�JF,fr*lt 05INCt 0 FTUOOFRA, • Y lv"wv f =l<�F'rl� IA44 U O�v "t'I"AU 09) CP) $[PAN LWVH W, LOAD 3280 W3 73W 21160 24 13m) 4373 A GMIAIC, ON y AM is PA)T YO A C%MkO waoj cy acri stems Ltd. 0 .12yS.I.Speir-spedf ica Lion Rov 03/99 WaVell, Ylkll�It 9 v % T Jr. 'M S, t, 11, 'D 1 16 Vi %,%,,I,, V Mkt i W, 1 1 All qp I k ap ',�" Y N tl4 a r e ¢+r« f u � kin i5 Y1I tq'1 .( 1 s! x , 1 N i v ti V n 1 e v I D .._dld._ ;«"'"ra'Rvf'I r �tlR �T"„ �.r •hQ(;} a y r tag ?fig � 6�� 0 9 p� � —� t —01 IN a a 0) M er IIVVIdd F 1 tt k JEFFERSON GENERAL HOSPITAL AS AfChrtects PC EIV , 1 ++� r UP I. SW 6 he r s, aw br 1N . P. Sheet • MC 1W • M' WW, 0 epa 9 5 �11"le w twq pyav;YM e �, � Q IottralteoezW.vrrew earanar ,,. _ .. N SPOI1434V S)4f I WRI, vl Ep cy 0- 0 IVIMSOH WHAD NOSMIJO H. HH mwa IF Project. PC,W*A Subject: Sheet 15— of Structural Solutions Originating Office: El 93'raComa '21 J mN, lob Nw�,--,yo Name: Date: S, v h AJ, If rn x44 Pori' C-,-F 'SO-YiN ))e 11 211�i 2 4 7 11, 3 0 0 z-4,7 - .,s" ol, Seattle Tacoma . ... . ........ ..... 81.1 Firsl PW C=tlVaa¢ Siffle 510 - Sowfle,'VVA %sp)q • tel: 950 Pacifk-,AV(tJLIC, Suite itao �T,&corn a, WA0402 - (el. 253.310,2797 mommalk lmmkb� Adwh& Project: F (-T" Suhject: Sheet Ar. f Structural Solutions Originating Office: ❑ Seattle coma C" 2-0 I.. . ...... Job No:, 46� Nal-fller L plate:., Vol )/ C f - p- + z5 k5� < �,+t ("5Y IS 18 �Et;i q soattle 8,11 FIrst Avenue, Suite 510 - Sctt(je,WA98104 . tel.206.292.5076 Ibcorna 1 950 Pacific Avonm Suite 1100,Abcoma, WA 08402 - tel. 253,383.2797 Unistrut Component Detail Page 1 of 1 11 ISiTRT the Original Metal Ff•oming Part No, Marion mred Sq4 irOi 8 8ack ( Download i)DF"T"° ( Add To Cart ( View Cart ( Download CAD Data P5501 - 1 5!8" x 4 718", 12 Gage, Back -to -Back, Solid 1 '4#gn" 1d.9 4 ) di� -Column Loa rliri,-Pa5501 Alloadbl� w e Max Coquamn Load A tlod at C,43 Slot Face Kv065 A6a 4 6 Channel Seleclion Chao Relaled Channel Nuts. Finishes: G$ PG )lG 2D PL Weight: 494 Lbs1100 Ft (735 Kgl100 m) A h-woI V➢aApolirorlti Elements of Section Area of Section - 1,452 0 (9A crir2) Axis 1-1 o Moment of Inertia (p - 2.805 in4 (116.8 CM4) o Section Modulus (S) - 1.151 Ins (18,9 cm) o Radius of Gyration (r) - 1.390 in (3.5 cm) Axis 2-2 o Moment of Inertia (1) - 0,660 in4 (27.8 cm4) o Section Modulus (S) - 0.023 Ina (13.5 cm3) o Radius of Gyration(r)-0.6701n(1.7 cm) NWwatato I Dan at Uniform uniform Loa load Lolwao Gracing Reduction Factor 1, Above loads Include the weigh[ of the member. This weight must be deducted to arrive at the net allowable load the beam will support.. 2. Long spat beame should be supported so as to prevent rotation and twist. 3. Allowable uniformly distributed leads are listed for various simple spans, that is, a beam on two supports. If load is concentrated M the a orngor+7tl tN1cn span, mul'bpt'y load front ons ta.b(a III corresponding deflection b) 0.6,. 4, The lateral bracing factors of o d be multiplied by the lead to doterrnlVno the load. to1amod Wood on lho distance bomoon untwo; braces, arrve Load on Channel: uu'AAD kfmaG1 Max Load Max Load 5,000 Lhs 8, Lbs 2268 Kg 3,620 Kg ft42005 br,L ,Wu All pCl;yVilm Ravmved tlmflsk V76 Isicn;+ll In'vi.4r"LC"arpa ned'unm Nmr l3nfi'6".xlan'Ills IS vkd21.[,,, dA,, Oh,ir r.oracu �,.`v N;6kAd'S d Max Load 3,500 Lbs 1,508 Kg tyrlCulllo, „,ipl MOM) rl"Kfiwoq, http://www.unistrut.com/Browse/cat—detail.php?S=S02&P=P5501 10/16/2008 Unistrut Component Detail Page 1 of 1 UNISTR T 9 The Original Metal Framing Part No. ASdN8016gd HG41 CGit 13 Back (" Download PDF'a ` ( Add To Carl ( View Cart ( Download CAD Data P5001 - 1-516" x 6 112", 12 Gciege, Sack -to -Back, Solid ll 7p' 90.,Y r N gtlfi N f q W u` - m m Loat{tlwsq PSQD9 FMax�CaWtapaa Load ITITIT_.. _ Agawablo Dag _.._ ........... ,.. � ...sumo __., D IIIY11t ).CJw'nGllil ) a�'Id)1 C3Qa m. Max aN h®karm Loattlfry Lateral DatlotlVolt Br, i Unbng [aced A a� tl C Unllorm Uniform up Vl >)prasw �Sppwry � RodUda N1OW11 Ka0-0, - 5 K 0p5 T NCsg.85 '�, LVOrm� Wood load 1i88 YSdtY I a30a7 .--`-- Channel ;;^,,olection_Chert etas; Rel4;CNy�hannel_Nuls 1. Above loads Include the weight of the member. This weight must be deducted to arrive at the net allowable lend the beam will support Finishes: PR PG HG, PL 2. Long span beams should be supported so as to prevent rotatlon and lyrist Weight: 3. Allowable uniformly distributed loads are listed for various simple 610 Lbs/100 Ft spans, that is, a beam on two supports. If load is concentrated at the (908 Kg/100 in) center of the span, multiply load from the table by 0 5 and corresponding deflection by 0.8, addii ona9 UVoOkmtopa 4. The lateral bracing factor should be multiplied by the load to determine the load retained based an the distance between lateral E,lornonts at Section braces, Area of Section- 1.793 ln2 (11,0 Cm2) I Oanring Land an Channel: Axis 1-1 ry¢,p,I!} 40A tA'AkaN o Moment of Inertia (1) - 6 227 in, (259,2 cm4) o Section Modulus (S) - 1.916 Inn (31,4 CM) o Radius of Gyration (r) - 1,864 in (4.7 cm) Axis 2.2 o Moment of cm4) • 0.966 in" (17 Max Load Max Load Max Load o Section dulu5 ModulusInertia S) (1.8 4,000 Los 5.500 Lbs 2.000 Lbs n (- 0.69Inn o Radius of Gyration (r) - 0,685 In (9.0 cm ) m) 1,814 Kg 2,495 Kg 907 Kg 1*" a n to t o ix <r 0 tgco FYr a^r+tie Of r�dvriorol v <ftlrcl.. wJo v„a,xletr LuvJu aim m. tl'uC uv la' o{rorwla u,.mr➢lc 'ta'.uUr'Of�a„ IT, dl01,l M,'. aortfi uuNvr.V a. icuuui,arc ✓kAUN4,P i9 ab1Ndf1"i'F http://www.unistrut.com/Browse/cat—detail.php?S=S02&P=P5001 10/16/2008 Unistrut Component Detail Page 1 of 1 l4 UNI SRU� The Original Meta) Framhlg Part No. � a ;y Aavm,cod Saarnh Bork (Download PDF`S'.' ( Add 7o Cart l View Cart ( Download CAD Dole Note: e When used for mechanical supports, load capacltlas of brackets and fittings should be In compliance with the American Standard Code for Pressure Piping. Finishes: 911 EC3 LICQ Weight: 72 Lbsr100 PCs (32 7 Kg1100 PCs) A W0oo0,0P,,a0 ooVgn4 P2676 - Beam Clamp IrVro..'ti Ae dr r ( Ih` X 2' Sol Snow A and NAL ,°� Ib ads^-}Ttlkh " // owrr/y%, rA^ f� �` •- 3wivol Nut aral ' W Jam Nut not µ Included 2 Helm B/ai `J q3.?,p (}iMp. r ^es'w.. B§ad `3i�e7 up 0 14. nod .544011 &'iQ AP,I AN teWKIToras 2 Holes "An' { I I .I) 01& Omer Rr9nlari K '..o- a,3.?.} think �iool. l,pI �a I� If 0nsrcy, 1 naafi 0-`Nl l t toad _.. 5(19ltrs 22n.g kr8} 31H) Lt,s (13E 1 kg) 06,013 P"m`I'LtO pmwrk'os a means al rod spolvvI1I6411 whoro a Roe Woo of uAp In I1,VIInu s') is dnrlrylrod. C.1Any w11 maarn rnoftoW(E.4), 'A` (9,51, or Yd (IZ7) rods, Ofdar swlvO nuts P2979 b; 6, ar.8 as mquUed. Clamlr may al.5o b0 u with P287T as gWtrat6d In application drawingn 'A, papa 11 3. _. ...... ......... 0 2605 UeW..1 Aa Rights R--d Univtruf�is a reflis—d trademark ar trndeniurA mf Ilnirirnl Coipurntim: nndRir iPx elTiliAtvs in theil L"d Motes nnNor otherceuninse tycocr�cz,, r� �rd!'fo"rf i°PLk�rfxi;P'.5 http://www.unistrut.com/Browse/cat—detail.php?S=S05&P=P2676 10/16/2008 Unistrut Component Detail Page I of I UNISTRUTI'lie Original Metal Framing Part No. 'Go) Advanced Svirrh 13 Back Download PDF Add To Carl Vlow Clint Download CAD Data -xm- n3WATflm P23588, P2401S, P2403S -Beam Clamp (1-5/8" Series} ICosoo4moo - am snow WQ.-- OU -s4b C'uIducliald Wall 156 Lbsi Pica (70,13 KWIOO PCs) AdAlUotool Opq00irptIol .............. call 1`44 'A' .811, i1c. -111' Wi 00 pu laid No [Vib v M h jnRim) iA to lial ttv4 Ii us go) ds^e W" v 2W For billijim Wwoon 1 (19,11) W Me (03) lihIck flanges, 02005 Wi An 1159hi U.n4ii,40ii. wim-i of donunr CwrArorbn multi id .0116— W.h. Efe01lierd & http://www.unistrut.com/Browse/cat—detail.php?S=S05&P=P2398S 10/16/2008 Unistrut Component Detail, Page 1 of l _0 Sthe Original Metal Framing Part No d Or '9acq �Downlaatl RDF dr`a ` „ ACtl to Cart C View Cart C Download CAD Delp Note: ■ mat used for onwhaaanfcaal supports, load capacities of brackets and finings should be In compliance with the American Standard Code for Pressure Piping, Flnlshes: Er yg Zpn Weight: 83 lbs1100 Pcs 07.8 Kg1100 Pcs) Additional 8pQ q(}rei}1Ons P2785 - Beam Clamp ?° Wax N111s and C7aelgaa Leaad,....I?asflr U' 130It Included f1"�N('Y t kqu Q4"Ki'.tih k�Dl U80 In f+1u1n 0"ll • For use with Dearns up to 90 (19.1) Flanges and with Channelf P1000, P1100, PZWD, P300, P3300, P3301, MOON. P4001, P4100, and 1`41111, 0 Rt'refti Alnl1ll1W All IWYghL, OEce+ .d 4PniwwvuLW+ w u ueyixtavr.5 iikAalevann,li ory to o�aunnrA v.vrt uIr ovomai ¢",wu�umoau'elno KK ulAo 16w m�iwPa 1 uu Ikw iv0000nd °1i.�ivv nnaa"mr ��OP,az ao�muoidex AcfvnnG9(1 SA}c�Yf: ri tyca rasarr'$W& 1211178 Prirrt "a var http://www.unistrut.com/Browse/cat—detail.php?S=SO5&P=P2785 10/16/2008 Installadon Specification � o:.. �Y� 1275-3 Straight Track - Aluminum/White Powder Coat µ NOTE; THIS DRAWING AND THE INFORMATION CONTAINED HEREIN IS THE PROPERTY OF WAVERLEY GLEN SYSTEMS LTD. AND IS NOT TO BE COPIED OR RE -ISSUED. 3 �- t✓s� MATERIAL 6005A—T6 ALUMINUM ALLOWABLE DEFLECTION DESIGN FACTOR OF SAFETY (10' PIECE, 600LB LOAD) 1/200 4 MATERIAL YIELD STRENGTH 37 KSI 42 KSI MATERIAL ULTIMATE STRENGTH 3.1559 SOUARE INCHES AREA DEFLECTION (10' PIECE, 600LB LOAD. SIMPLE SUPPORTS) S08" THIS DRAWING IS A GUIDFa1 INE ONLY, AND IS NOT TO BE' CONSIDERED AS A CONSTRUCTION DRAWING. Waverley Glen Systems Ltd. 1275-3.spec.speclf ication E. & O.E. I 41 iI Letter of Transmittal November 13, 2008 Washington State Department of ijeulth 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# 60057139 Project 834 Sheridan St Jefferson Healthcare Hospital location: Pt Townsend, WA 98368 Chapter 246-320 WAC 1, lospitals Pat icut Lifts - 3d & 2"' Floor Local Permit #: Key People: Assigned DOH Matthew Campbell Reviewer: matthew.campbell@doh.wa.gov Facility Jefferson County Public Healthcare Facility Contact: Same As Administrator Administrator: Dana Michelsen 834 Sheridan St Pt Townsend, WA 98368 (360) 385-2200 dmichelsen@jgh.org Architect / Coates Design, Inc. Building City of Pt. Townsend Engineer: Bob Miller-Rhees Official: Leonard Yarberry 921 Hildebrand Ln, Ste 210 181 Quincy St. Suite 301 Bainbridge Island, WA 98110 Port Townsend, WA 98368 (206) 780-0876 (360) 379-5095 bob@coatesdesign.com larberry@cityofpt.us rtaylor@cityofpt.us Sprinkler / NA Fire Alarm N/A Contractor: Contractor: Other: N/A Other: N/A Copies To: ® Local Building Official: City of Pt. Townsend ® Architect / Engineer: Coates Design, Inc. ❑ Sub -Contractor: N/A ❑ Sub -Contractor: NA ❑ Other: ® Washington State Patrol, Fire Protection Bureau ® CRS File ❑ DOH Child Birth Center Licensing ❑ DOH Office of Accommodations & Res. Care Survey D DOH Office of Health Care Survey El DSHS, Div. Of Alcohol and Substance Abuse ❑ DSHS, Aging & Adult Services Administration ® L&I, Bill Eckroth, Electrical Section ❑ L&I, , Factory Assembled Structures Page 1 of 1 Plan Review Comments for Project #60057139 Jefferson Healthcare Hospital Chapter 246-320 WAC Hospitals Patient Lifts - 3rd & 2nd Floor Memo: - Authorized to Begin Construction - The construction documents have been reviewed per Chapter 246-320 WAC Hospitals and found acceptable. Construction can begin without delay, subject to construction permitting from the local building official. The stamped approved copy of the documents shall be kept and available for the licensing staff on site. Please note the following: • Any changes/deviations (incl. change orders or addenda) from the approved documents must be submitted to the Department for review and approval. Please include your CRS number on all communications to Construction Review Services. If you have any questions please feel free to contact Construction Review Services. You can monitor project status and fill out our online survey atxvyltbl;Tv,,er ads Page 2 of 2 Plan Review Comments for Project # 60057139 Facifity'Da ta_Certificate: Facility Name: Jefferson Healthcare Hospital Licensee UBI# 600154888 Site Address: 834 Sheridan St Critical Access Facility: ❑ Yes Pt Townsend, WA 98368 ❑ No Estimated Date of Occupancy: Occupancy Group: I-2 Construction Type: 1-A Applicable Code: 2006 IBC W.., .._ Number of Beds: Current: Added: Removed: Total: >4 Automatic Fire Sprinkler System: ® Yes ® No Type 13 ._............................... __._. . a Automatic Fire Alarm System: ® Yes F-I No Compartmentation req'd: EYes ❑No Smoke Control System Provided: ❑ Yes ENo w aSpecial Delayed Egress Control: E Yes ❑No Location: ...... ........ Certificate of Need Required: 0 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 U O Based on size of common rooms Residents Maximum allowable licensable beds: w a .-----__.-- ....................................... Qualifies for Assisted Living Funding Program U ....... Yes ONo Number of qualifying units: ..... ......... ....... W� a w 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 3 Plan Review Comments for Project # 60057139 Jefferson Healthcare Hospital Chapter 246-320 WAC Hospitals Patient Lifts - 3rd & 2nd Floor ❑x Approved 11/07/08 —Based on design information submitted and contingent upon: No fixed rail of the patient lift system shall be installed within 18" of sprinkler heads. If equipment other than the 3.5" deep fixed rail is planned for installation at any location additional review will be required. Compliance with the comments above provided by the Department of Health, Construction Review Services, are necessaryfor 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 4 of 4 Plan Review Comments for Project # 60057139 Construction Review Services . ome Page Page 1 of 2 Facifites aud Services Uteri rig Oneal'th 01 SERVICES You are here: DOH Home » HSQA » FSL » CRS Site Directory: onstruction Review Services (CRS) MSshingtono CRS: Project Status Facility Name : JEFFERSON HEALTHCARE HOSPITAL Facility City :PORT TOWNSEND Project Type Hospital Project Project Title : PATIENT LIFTS Project Number Project Start Date Project Status Project Status Project Close Date Search I Employees :60015575 :0411212006 n : AUTHORZZEi TO BEGIN Note: For sortinwq, click the column headers below. Project Details Status Target Items Item WorkFl Date Date Received Status Descril (1) i 6/20/2008 Fire Sprinkler System Construction 2 Approved Plan Re Drawings 6/20/2008 Fee Paid 2. Approved Plan Re 1 Page 1 of 1 Show All Please note - Approval of an individual item does not constitute full approval of the project. An individual item can receive approval, but there may still be additional information needed from the facility in order for CRS to provide full approval of the project. It may be a violation of the rules to begin construction before approval has been given by CRS. Projects without an item review completed date have not completed the plan review process and may not be occupied. To report errors found in the data presented on this site contact (360)-236-2944 or email us at dohfslcrs a�doh.wa.gov. DOH Home I HS A QnJfte..$$e r..h I tie ess Washingtan I Privacy Notice I Disclaimer/Q py_righ Information Washington State Department of Health Construction Review Services P.O. Box 47852 Olympia, WA 98504-7852 Phone: (360) 236-2944 Fax: (360) 236-2901 Driving DI rections Last Update : 02/13/2008 04:22 PM https:Hfortress.wa.gov/doh/constructionreviewlookup/step4-project-profile.asp?pid=6001... 10/22/2008 FUNCTIONAL PROGRAM The installation of patient lifts at Jefferson Healthcare was driven by the need to provide safe care for an increasingly larger bariatric population, as well as the need to provide safeguards to the employees and retain a healthy staff. With the shortage of qualified workers at a crisis point, there is no room for worker injuries that can cause time lost or a turnover of staff. In addition, the nursing staff on the top floor is ageing and the lifts will make it possible for them to adhere to the "zero lift" requirements. The lift equipment that will be installed in this project will be on the third floor, which includes: Med/Surgery, ICU, OB patients. In additional the CT room in Radiology will also receive a 16ft Track and fixed lift. We will track all of the rooms on the top floor, providing as many fixed lifts as the budjet will allow with the remainder being portable lifts. We at Jefferson Healthcare are striving for an injury -free environment for both our patients and employees. We are also aware that Washington State legislation makes safe patient handling part of how hospitals provide care by adding this requirement to hospital licensing. . . .. ....... ..... � yI . . ......... J Ji u C�f)i Infection Control Construction Permit b� W �,�.... Permit Nxwa 0 C)I Location of Construction Project Start Date: 0 PL_ect Coordina o , _ Estimated Duration.6 Contractor Performin work crDate:/�7� Penrdt ExpirationDa Supervisor: Tele hone: ._ NO CONUCIiON ACTIVrrY YES vFsSTR NO WFF.CCION CONTROL RISK GROUP m _ TYPE A- Inspection,000-invasive activity _ GROUP 1: Low Risk TYPE B: SmO &sale, ahorE'aivatina; GROUP 2: Medium Risk moderato to hi�evels _ TPEYC_ Activity generates moderate to high [ovals of OROUP 3: MaunV/ Ugh Ride _ dust, ►eVires grcuer I work da for scrip letagn_ TYPE D: Major duration and eonsttvction activities GROUP C Highest Risk Reauirinz eoasecutive work shifts CLASS I V Execute, worm by methods to "doirnize raising dust from 3. Minor Demolition for Remodeling copstrtretton Operations. 2.. Immediacly replace any ceiling file displaced for visual tns�tott. _�_ CLASS 12 t Provides active means to prevent air -borne dual from 6. Contain construction waste before transport in tightly dispersing into atmosphere covered containers. 2. Water mist work surfaces to control dust whilc tinting. 7. Wet mop and/or varuum with H EPA filtered vacuum 3• Sea] uoused doors with dud taper before leaving work area. 4. Block off and seal air vctte 8. Place dust mat at entrance and exit of work area. S_ Wipe surfaces with disinfectant. 9- Remove or isolaatai HVAC system in areas wbere, work: is beirtgperformcd, _ Tu efare catt;tructioa begins. 6. Vacuum work v+itb HEPA fiherod vacuums. 1. Obtain infection control pa-mitb_ CLASS U 1 2. Isolate H VAC ystcm in area wbere work is being date to 7. Wet mop with disinfectant prevent eoataunination of the duct system 8. Remove barrier materials rarefuBy to minimize 3. Complete all critical barriers or implement control cube spreading of dirt and debris associated with method before oocaruction begins construction. d 9. Contain construction waste before transport in 4afe 4. Maintain negaativo air pressure witWo work site utilizing tightly covered eontainem HEPA equipped air fiftNion units 10. Cover transport receptacles of carts, Tape covering, S. Do not remove barsiers from work area until complete 1 1_ Remove or isolate HVAC sysietat in areas where work projed is thoroughly Cleaned by Rav- Servic4s Dept is being performed/ 1. Obtain infection control portal before construction begios. 7, Alt personnel entering work Site arc required to wear Class N 2. Isolate H VAC System in area whore work is being done to shoe covers prevent contamination of duct system. 8„ Do not remove barriers -from work area until completed 3„ Complete all critical barriers or implement control cube project is thoroughly cleaned by the Environmental method before consitudioo begins. ServicaDept Date, 4. Maintain negative air prmsure within work rite utilizing 9. Vacuum work area with HEPA filte ed vacuums. HEPA equipped air filtration ,MAC 10. Wet mop with diSieWiAAL S. Seal holes, pipes, conduits, and punctures appropriately. 11, Remove barrier mattsials cattfully to minimize 6. Construct anteroom and rupiro all personnel to part spreading of dirt and debris associated with through this room so they can be vacuumed using a HEPA construction. vacuum cleaner before leaving work site or they can wear 12, Contain eonsin dion waste before transport in tightly cloth or papa coveralls that are removed each time they covered coufainem. leave the work aita 13. Cover transport receptacles or carte. Tape coveting. 14. Remove or isolate HVAC aystan in areas where is . m 61 done. Additional R irena Date 0-7 Crete "otsAdditirtps tritrs pate rar�taa Peal Request By. PetnaR �i _.._ Dam: r � Date: � 4 C III 1' k m,a Adapted with permission V Kennedy, B Barnard, St Luke Episcop j Flos�pital„Itotwstor~�� 5 Forms modified and provided courtesy of I Bartley, ECSI Inc Beverly Hills HI 2002 n4w Receipt Number: OIS-091,541, Previous Payment History ReceI t Recel t Date Fee be criptioa Amount Paid Perm It Payment Check Payment Method Number Amount CHECK 70874 $ 150.00 Total $150.00 genpnitrreceipts Page 1 of 1 Look Up a Contractor, Elecil clan, Plumber or Elevator Professional License Detail Page 1 of 2 Information in Spanish Topic Index Contact Info Search Home Safety Claims & Insurance Workplace Rights Trades & Licensing Find a Law (RCW) or Rule (WAC) Get a form or publication @'1alp � r t Return to List > Start a New Search > 0 Printer friendly General/Specialty Contractor A business registered as a construction contractor with L&I to perform construction work within the scope of its specialty. A General or Specialty construction Contractor must ) maintain a surety bond or assignment of account and carry general liability insurance. r. Business and Licensing Information Verify Workers' Comp Premium Check for Dept. of Revenue Account Status Name MC CONTRACTING UBI No. 602742133 Phone No. (360) 791-0948 Status ACTIVE Address 141 E CLAYTON License No. MCCONC`931MZ LN Suite/Apt. License Type Aj CONSTRUCTION CONTRACTOR City GRAPEVIEW Effective Date 7/9/2007 State WA Expiration Date 7/9/2009 Zip 98546 Suspend Date County MASON Previous License JMMECMM943NH Business Type INDIVIDUAL Next License Parent Associated Company License Specialty 1 GENERAL Specialty 2 ? UNUSED Business Owner Information 9 Hide All Name Role Effective Date Expiration Date 'CLAYTON, MARK OWNER 07/09/2007 Bond Information i) Bond Bond Bond Company Account Effective Expiration Cancel Impaired Bond Received Name Number Date Date Date Date Amount Date AMERICAN 1 CONTRACTORS 100027733 07/05/2007 Until $12,000.0007/09/2007 INDEM CO Cancelled Insurance Information All https:Hfortress.wa.gov/lni/bbip/Detail.aspx?License=MCCONC*93 I MZ 11 /10/2008 Page 1 of 1 Suzanne Wassmer From: Suzanne Wassmer Sent: Monday, November 03, 2008 8:34 AM To: 'dan@medinc.info' Cc: 'dmichelsen@jgh.org' Subject: Building Permit BLD08-218 This e-mail is to let you know the building permit for the installation of the patient lifts at Jefferson Healthcare has been approved. However, before we issue the permit we need a current Washington State L&I number and a city business license for the contractor. The application lists "Angel Solutions" as the contractor, but the license numbers were not included. On October 20, Mark Clayton called and said he would apply for a city business license, but our records show we have not received it yet. Thank you. Suzanne Wassmer Land Use Development Specialist 11 /3/2008 Receipt Number: 6-1104 " i e ipt Date. "12/1712008 Ca hler. Fk6NTDJESK Payer/Payee ?^ian'e; J FF' SON CO PUBL HOSP DiST 2',; , Original Fee Amourl't Fee PermiIt/i Parcel Fee'eacriptloeu Arinouurit" Paid Balance BLD08-218 948321101 Building Permit Fee $363.25 $363.25 $0.00 BLD08-218 948321101 Plan Review Fee $236.11 $86.11 $0.00 BLD08-218 948321101 State Building Code Council Fee $4.50 $4.50 $0.00 BLD08-218 948321101 Technology Fee for Building Permit $7.27 $7.27 $0.00 BLD08-218 948321101 Record Retention Fee for Building P $10.00 $10.00 $0.00 Total: $471.13 Previous Payryient History RZcelpt'# Receipt Date Fee Description ,Amount Paid Permit ' 08-0954 10/16/2008 Plan Review Fee $150.00 BLD08-218 Paym a rat Check Paym a nt Method Nu m ire r ,Amount CHECK 071725 $ 471.13 Total $471.13 genpmtrreceipts Page 1 of 1 City of Port Townsend Development Services Department 250 Madison Street, Suite 3, Port Townsend, WA 98368 WA61 (360)379-5095 834 SHERIDAN ST UMV-24143 Application No BLDOB-218 Project: Install Patient Lifts (31 rooms with tracks, 6 Iffts remain in the rooms & 25 portables) Application Type Comynerciat Miscellaneous Parcel # 948321101 Subdivision: EIS BETS ADDITION Block/Lot Site Address: 834 SHERIDAN STREET Description Building Permit Fee Plan Review Fee State Building Code Council Fee Technology Fee for Building Permit Fee Amount Paid/Credit Balance Due $363.25 $0.00 $363.25 $236.11 $150.00 $86.11 $4.50 $0.00 $4.50 $7.27 $0.00 $7.27 $10.00 $0.00 $10.00 Total Fee Amount: $621.13 Total Paid/Credits: $150.00 Balance Due: $471.13: Payment due within 30 days Invoice 7�1 � Receipt Number: 08-1104 Receipt Date: 12117/2008 Cashier: FRONTDESK Payer/Payee Name: JEFFERSON CO PURL HOSP DIST #2 Original Fee Amount Fee Permit # Parcel Fee Description Amount Paid Balance BLD08-218 948321101 Building Permit Fee $363.25 $363.25 $0.00 BLD08-218 948321101 Plan Review Fee $236.11 $86.11 $0.00 BLD08-218 948321101 State Building Code Council Fee $4.50 $4.50 $0.00 BLD08-218 948321101 Technology Fee for Building Permit $7.27 $7.27 $0.00 BLD08-218 948321101 Record Retention Fee for Building Per $10.00 $10.00 $0.00 Total: $471.13 Previous Payment History Receipt # Receipt Date Fee Description Amount Paid Permit 08-0954 10/16/2008 Plan Review Fee $150.00 BLD08-218 Payment Check Payment Method Number Amount CHECK 071725 $471.13 Total: $471.13 genpmtrreGeipts Page 1 of 1 7 Q Co O O Co CD CD O O M r r CD O O r M O O O O O O O O a)CDO O O O Clw ClO 0 r r r Y - T N s� O m T O' 00 OD M N T T N t0 M M M M M M M N e O t, O N 0 N M G O O O N w O N of r O O O O O CO O O — to M r O Co O O 0 T T r T r O r r r O C. to C. t0 Qr C O O O O O Co O O O C O O O O O O O O 3 O O O O O O O O O O Q T r T r T r r T T r r T T T r r N I.L O O O O O O O CD O CD O a O O O O O O O O O O O W 1n r O O O CI CI T T r T r CD r r r O Co to O O CD O 0...., to O_.. I` r........0........ M O O O N O N T to r r N In M CDI.- W Iq T M N M W r 00 to M N T M to to N N 61) CA to to),m to to 69 fA try 3.w O O O Q N n 0 O W U �_ W U co ~ 2 w a LL co LL co H LL cod LL W O H Q cn x W c U 0 0 N 0 0 to 0 U ~ r N a O x a O x a O x a O x a O x LL r m m m m m o z z z a a a a a LL g 0 U 0 U 0 U 0 U 0 U z z z 0 0 0 0 0 W Y W Y W Y W LL W W LL W W LL W W LL W W LL W LL LL LL w w 00 aD 00 00 00 00 O O O O O O O O N N N N N N N N Wes. r T r r r r r r aD N N N N N N N N YiU r r r r r r r r M M M e} �t Mu. O O O O O O O O WM' T T r r r T T T tt� r r r r x 4 O O N N N N N O O C.O C. O O O a_ a_ _a o 0 0 0 0 J J J J J 03 H 00 O O O to N -4 O O th N O V7 le O le 00 O 00 N O N M V7 ti M M 00 .--I M O M �Nl1 tn M N N 00 00 y bD cd a q o 0 0 0 0 0 0 0 0 0 0 o 0 0 0 0 o O o 0 0 0 U C o o CD o CD o 0 0 0 r a� z OJ O O O O O O O O O O O bD O O O O O O O O O O O CC N O O O U U En q c q Pam. Pu. tu 't8 U U U � OD a� ti 0 b s. oA O oA o Cd kno N N N O r� N o Gov 00 O 00 O Ntu vl U U knM N N CYd 3 M 'a" V) V7 00 00 c a a cn O O O O O O M.- O O i O ": O D O O N Cd Cl ^ O0p O ^ Opp O O M O N O N OC 0C,, 00I O� OOO 000 O 00 C 00 C It M C N M O N MC) Cl Cl 'et CD00 M S O O O U M O M O O N N m G 00 �� O II O O O O O i kf) 4n - O O O O M 01 O\ C '. C I, CD kn U U U O U O U O U O U O U O O O v, O O O O O O O O O O O O O O v o 0 0 C 0 0 0 C o00 C O O O cq N N V1 00 O 00 O O N .--� M wi M M �O 00 M 0 M N N V1 M M r1l rq cq eq In 00 00 Q N N A A A A A cn cn V) Gn V) x x x x x a a a a a 0 a 00 Q, a a Q F 0 a � uU OU OU uU OU o. ors: 0C4 � Cti' Za Z� Za ZG4 Zw' d> d o zu z� zu 0u 0u 0u 0u 0u aoa j.d P Y P Y (4 Y U� cn �+ U) Y V] Y cn Yp 04 00 \ 00 b '� W b W •,� W '� W •� W '� r r ri N a 'a 'a tia 'a zA wa wa wa 00 O 00 O 00 O 00 O \ 00 O \ 00 O 00 O \ 00 O N C \ SON \ SON \ �O� 01 �01 O� �O1 �Q �'+ ON N O\ O1 N ON O� N O1 ,n-i� N Q1 .�. \ 01 N O\ 01 N O1 .�-i \ 01 N 01 01 N ON 01 ON C7,N O � Z �+ O O 00 O O 00 O O 00 O O 00 O O 00 O O 00 O O 00 O O 00 0 O O O 00 O O 00 O O 00 O O 00 O O 00 O O 00 O O 00 O O 00 to U O O O O O O O O O O O O 0 0 O O O O O O o 0 O O O O 0 0 O O O O q .y 'C a •o a O z vl kn kn kn W) tn00 P� d 00 00 00 00 00 00 00 u o 0 0 0 0 o U 0 0 !" M'g 4q 1pMp3 bi b o N C5 w u n OP O 1 pypQ1� A W M " 9 H m N W N G 'p tr■� 1 n m d w n Am m. b t] M F N O w S a U TOOIM UOTIOMI�9UOD Hf TZtT99C09C YVd 2C:C9 6009/OT/fO vom Jo t o 39 i a s rq m Wm om njM (' o a m a lu A h u NIL T00UOTaDnJaSU D Hi TUVTSRC09C YVA 9R-90 6009i0T/ro 04/10/2009 08:56 FAX 3603851421 *122000166* 12/19/2006 Co -65958897 a Ca nj Th I i s L EGAL COPY of `% chock. You can use d youGhog � CO m a� a b Ln �� ^ theoriginal check, ru Yq®9 a ap rq rn F P m C3 m 1 Y 1 r 6 ru m C3 C3 ry Iry9 !! rua V JR Construction 824 M PORT k :f 0! PORT " TDWUSMI cm or THE c`Yx . VENDoRWAQQQl.y3 E. tTo --n' FROM AW M GDMRAL FUND An-M i yw MW 1-ce City of Port Townsend Development Services Department 250 Madison Street, Suite 3 Port Townsend, WA 98368 (360) 379-5095 Fax (360) 344-4619 COMPANY/AGENCY: FAX NUMBER: _ .......... �_.�._...... DATE: FROM:......— —_ I ` . ........... SUBJECT:..m . _ ...... .. . M _ TOTAL NO. OF PAGES INCLUDING COVER SHEET: Co,HMFN, Permit Query Pagel of 2 Thurnay April 212W9 1 NO Application PP PP tatus ermif � rm Applicant PP R a Aect P Parent Application Project Name Street Submitted Approved Issued Dt Reissue No Type P P Type name NoAd dr Dt Dt Dt Bur}oo z25, C FINALEDENERAL LEG BLD 1EFrFkSON l -' — 948311202 c^ 1 ...m,,,,., REMODELXkFlY....,., ROOM 3 .. 434. SHERIDAN �. II/17/2000 01/30/2001 C. 02/14/2001 HOSI I CAL L.H 1--- I CBLD0108C� COMPLETED �BLF) . — HOSPIFAL�9 18321001�— ... _. REPLACE WINDOWS .: 14 S7SHERIDAN �VO4/18/2001�„04(20/2001II(}t/J4/7001�^^^�� .. ff ..,.. �BLD03 293 FINALED LEG- BLD JEFFERSON GENE 94`3321002�.........�FOUNDATION FOUNDA PION FOR MFtI 834 SHERIDAN � 12(II(2003 1111717(}03..� 17(21(700 � uu 11 AL. rll ff ... ...._�� C293WI FINALED � FL3I D �)4d3?f(}02 ` �07(27l2004 }7(?7/?0(}4 �Cp I�OS((}4(70(}4� HOSPILAL HOSPITAL BRACING/SIDEWALK SHERIDAN CBILD04 1?2 FINALED �C GENERAL 948319202 a834LEG FtE SKIN � NEWC3LDHOSPITAL WINDOWS SI 12/14/2004 08/29/2005 10/25/2005JEFFERSON 4- �1322R1 FINALED .. _I LEG- BLD wrM,RMVN L ��948319?()7 ASBESTOS. ETC^ iSH[RIDAN 834 HOSPF-f SHCkIDANO]/27/2005�(}3124/10(}506/(}7/1005 BLD(}4 237 1� FINALED mm FOLD I G GENERAL Os IFS °N. 948321002 Cmm �� C LNz 1 Ok AREA SHERIDAN SHERIDAN _ lC� /2004 F 08/27/2004 09/21/2004 a� l 1[ ...... m441T _,m.... ,.. 834 II31_D04268FINALED LEG BLD GENERAL �94831920? MECHANICALWORK�SHERIDAN�10/01/2004�10/01/200410/28/2004 uu tVtV1EFFERSON HOSPITAL uufl d S I 11 p BLD(}4 273 FINALED LEG- BLD IEFC ERSON HEA 948319207 4 MONUMENT SIGNS 834 � �10/05/2004 II((}3l20(}4 I1(17(700�I�mn M �� , SI1fTRIDPN uu BI D0 05 _,..m....... FINALED LEG .. 948321002��-- � Scanner Mobile Units 834 10/17/2005 �10(17/2O(} TIE` BLD HFJEFALT CARE HEAL Ff [C'AKL uNNgN CI SHERIDAN10/17/2005 sk IIIIu C...,.. BLD05216 FINALED LEG- BLD fEFFERSON 1 l HEALTHCARE032MOImm c 71Strew tsiPnat 834..... ISHERIDAN10/06/2005 10/06/2005 „ 11IM3ON5I--- u J ` JI S 7 11 BLD05 41 FINALED LE B LLSON HLITICAkE 15319302 Fire irm qeun 834 1p k1DAN 022/0200 1200015}1060GS : F3L D06 160 -------_. FINALED LEG D lEF} N GI NFRAI )443191(}� . ORTHOPEDICCLINIC SPACE SHERIDAN 08110(2006�08110(70(}6� 0910617006�� II USPfEaI SI BLD07 170� _._.... 1R,, FINALED OM �903192071� -- - OFFICE t0 URGENT CARE SH SHERIDAN OS/ VM07 110/05(7.007 ... 10MV2007 p JMISC HOST DISIvz_' u —IC _- 11 f —... (..ER}........�... 'r PA1 tFN"F S -- �BLD07 18I FINALED M CO PUBL N-7 948319202 �.�— UFTS (L LIF FS SHERIDAN 08/27/2007 I10/01/2007 1011012001 l 11111u11 TI DIS BLD08-119 C EXPIRED BLD COM .....I CO RUBE � 83?1.. 101 `.,.` C�,,,_...... BIRTH CEN [ER CHANGES SHERIDAN � OS170170(18 �V.� 10171(?008 C � MISC HOSP ISON HOST D75C ? f` AVENUE . BLD08-218 FINALED C'OM COIF UBION � � 94U I IOi rooms Pith t'acks156li1Cis ,AV ...., SHERIDAN RIDAN 10. /16/2008 10 0 I11/10/2008 :.... 11(10(2(}(}8 .. MISC HOST DIS7 `2 remain in the rooms 8. remain25 in the STREET BLU9408 12 FINALED LEG- BLD RA IEFFERSO=.... GENERAL c 007 )44371 HELIPAD .., „ ADF7IONlNEiV SHERIDAN f (}8l13l1994 �l f l 05(2 i/1994 HOSPITAL S F4 1 BLD9503- 15 .. .� .. C OMI LE F IE V.) LEG- BLD ....:...... IEFf RSON CO PUBl 948319702 948319202 __- ALARM FIRE ALAF ... 834 SFLRIDAN� ._ 04/10/1995�ij ^Nmm 04110/1945 HOSIV DISI 42 CCC t lu 00120BLD96 f C OMI'III FD BLD SON 1)4R319I(}7 CHOSI' FDIS �B ...,....r.... OFFICE ROOMS TO EXAM 834 r Ek1DAN �C.. 08/16/1996 �,.. 08!?91199(i� V F S -`-`- ____- . BLI- 0Q0797 �FfNAI_[ ..... D ...._._. LEG- BLDIIClSf ........;µµIC.. JEFFERSON CO IBL ��445319?(}2�� .,, .__ _._..- N TETE ........ 834 SHERIDAN 02103(199/II...., _� ........ ....... ...... (}2(07(19�� . .... ........�' I51 .2 13{(}i77 j,zPLETEDJ[�' -...� 111 f F I ItSC}N COPIIIE3L 918319?07 m..,STOAI}CWAI ..,,.,..... ,� INSTAiI FOUNTAIN 834 S}IERIDAN1V03/]0/1997L.. 1.�„ (}4((}3lL — t}0 31 1) TIC}5F D1S I x _,,. ,, . 57 ,....,. —. _997�� u http://permitserver:7778/forms90/PermitAttachments/html out/Permit%20Query.html 4030009 Permit Query Page 2 of 2 http://perm i tserver: 777 81forms90/Perm itA ttachmentslhtml_out/Permit%2OQuery.html 4/23 /2009 City of Port Townsend Development Services Department 250 Madison Street, Suite 3 Port Townsend, WA 98368 (360) 379-5095 Fax (360) 344-4619 TO: COMPANY/AGENCY: FAX NUMBER: °� DATE: FROM: SUBJECT: TOTAL NO. OF PAGES INCLUDING COVER SHEET: COMMENTS: L16 A S Tu�Cpe Luc os_o1 ? City of Port Townsend RESPONSIBLE OFFICIAL'S AMENDMENTS TO THE SEPA ENVIRONMENTAL CHECKLIST AND THRESHOLD DETERMINATION Proponent: Jefferson Healthcare, 834 Sheridan Street, Port Townsend, WA 98368; Contact: Dana Michelsen, phone: 360-385- 2200 x2066. Proposal: Construction of temporary (and possibly long term) parking area for approx. 32 spaces ("Parking Area 1") on empty four -lot parcel at 7`h and Cleveland Street (east of Manresa Castle). Also, future re -development of onsite gravel construction staging area near stormwater pond to permanently enlarge onsite parking lot (approx. 40 new spaces —"Parking Area 2"). Relocation of parking is required during repairs to existing hospital buildings. The hospital will be required to provide a long-term vehicle circulation and pedestrian plan prior to the City approving Parking Area 1 as part of a long-term parking solution. There is an eagle nest within 800 ft. of the proposed work, which may restrict timing of heavy equipment use or require other restrictions on development and use of property, especially during nesting season. Location: Parking Area 1: east side of Cleveland Street between 7`h and vacated 6`h Streets, legally described as Eisenbeis Addition, Block 240, Lots 5-8. Parking Area 2: on existing hospital grounds, legally described as Eisenbeis Addition, all or portions of Blocks 192-193. 210-212, 218, 219, and 220. File Reference: LUP05-019 Date of application: 3/4/05 Date of determination of completeness: 3/4/05 Date of public notice: 3/9/05 Other permits required by other agencies, to the extent known by the City: Street & utility development permit; building permit, grading permit. Lead Agency: City of Port Townsend, Development Services Department The lead agency for this proposal has determined that it does not have a probable significant adverse impact on the environment, as long as certain mitigation measures are adhered to. An environmental impact statement (EIS) is not required under RCW 43.21C.030(2)(c). This decision was made after review of a completed environmental checklist, stormwater plan and other information on file with the lead agency. This information is available to the public on request. This MDNS is issued under 197-11- 340(2); the lead agency will not act on this proposal for 15 days from the date below. Comments or a written statement appealing the threshold determination must be filed with the Development Services Department by 4:00 p.m., May 5, 2005. Location of documents available for review: City of Port Townsend, Development Services Department, 11 Quincy Street, Suite 301A, Port Townsend, WA 98368 Contact: Jean Walat, Planner I (360) 385-0644 Contact: Jean M. Walat (360) 385-0644 Responsible Official: David Wright, Interim Development Services Dept. Director Waterman & Katz Building 181 Quincy Street, Suite 301 Port Townsend, WA 98368 (360) 379-5081 Signature:'s al�J �� "7i��... _.__...... � �� ate: April 20, 2005 d've _ . Wnght,Interun I erector opment Services Department SEPA Appeal Deadline: May 5, 2005 Waterman & Katz Building 181 Quincy Street Suite 301 Port Townsend, WA 98368 Phone (360) 379-3208 Fax (360) 3857675 CITY OF PORT TOW SEA [ M i SO s - O Z4 GRADING PERMIT & INSPECTION RECORD THIS CARD MUST BE POSTED AT CONSTRUCTION SITE Call 385-2294 for Inspection Permit Number: M SO4-029 Issued: 10/26/04 Parcel Number: 985-204-801 Job Address: 834 Sheridan Street Zoning: C-1 Nature of Work: Remove vegetation, install silt and chain link fencing, catch basin inserts.. and construction entrance for future construction work staLying area. Owner: Jefferson General Hospital Contractor: Kirtley-Cole Associates Inc. - KIRTLCA272RF The following temporary erosion and sediment control measures to be installed and inspected prior to construction: Install catch basin protection as shown on approved plans. Install silt fence perimeter protection as shown on approved plans. Construct surface water controls (i.e. interceptor dikes, etc.) Construction entrance to be off the parking lot on the west side of the hospital. Inspection by public forks Inspector require call 385-2294. Date Continue to maintain and inspect the above best management practices as required by weather changes. Adjacent rights -of -way shall be kept clean of mud and debris from the site. Failure to comply will result in all work on the site being stopped. Clearing of vegetation per scope of work only; future construction and/or earth filling activities shall be covered under separate building permit. Any change to this proposed schedule shall receive prior approval of the Building Official. No earth removal is permitted, and disturbed areas shall be hydroseeded upon project completion. Page 1 of 1 PERMIT NUMBER: Site Address Contractor 0_'M m . M m...� ... ... .._ . Owner Date of Inspection Worksite or Cell Phone# ❑ Erosion/Sediment Control ❑ Setbacks/ Footin gs/U F E R ❑ Foundation Walls ❑ Footing Drainage ❑ Slab/Interior Footing/Insulation ❑ Groundwork/Plumbing Test ❑ Underfloor Framing ❑ Ext. Shear Wall/Holdowns M UPm, f 3�-�396 ❑ Plumbing/Top Out ❑ Propane Pipe/Pressure Test ❑ Propane Tank/Line ❑ Mechanical ❑ Framing ❑ Insulation ❑ Interior Shear/BWP Nail ❑ Drywall/Fire Wall Y OF PORT TOWNSENL DEVELOPMENT SERVICES DEPARTMENT INSPECTION REPORT �...._. __ m.�._................... ..."........ ............................._..��.w__..... .1 PVC �: r , ❑ Propane/Wood Appliance ❑ Manufactured Home Set-up ❑ Fire Department ❑ Temporary Occupancy ❑ Fees Paid >Uinal Occupancy ❑ Other/Corasultati'on Additional fees may be assessed for multiple re -inspections. For Re -inspection, call Inspection Message Line at (360) 385-2294 prior to 8:00 AM. (NO OCCUPANCY UNTIL APPROVED BY DSD. �__ __'__ ,OCCUPANCY REQUIRES WRITTEN APPROVAL BY DSD.) ❑ APPROVED ' APPROVED WITH CORRECTIONS ❑ NOT APPROVED � SEE BELOW SEE COMMENTS BELOW jo�j PP N o i pection. Approved ns and permit card must be on -site and available at time o Inspector Date Acknowlpe d b Date FAX City of Port Townsend COVERDevelopment Services Department 250 Madison Street, Suite 3 Port Townsend, WA 98368 (360) 379-5095 Fax (360) 344-4619 TO: COMPANY/AGENCY: FAX NUMBER: - DATE: _- FROM: _ r ....__.�._ ._ SUBJECT: '- L TOTAL NO. OF PAGES INCLUDING COVER SHEET: l `® kA-S iE L � LL- 111 1 "" — D Page 1 of 2 Scottie Foster From: Tom Aumock [taumock@cablespeed.com] Sent: Wednesday, March 18, 2009 9:31 PM To: Art Jones Cc: Scottie Foster; Charles Tandy Subject: Re: FPP08-07 Clinic Fire Alarm System Attachments: City Fire Alarm System Materials & Test Cert..doc Hi Art! I have been asked to respond to your question by the City of PT. The City of PT is currently trying to close all the previous permit files that are incomplete. Apparently, prior staff members were unable to record the proper paperwork to properly close the files. In addition, I have been working to merge the Fire Department files with the City to this end. However, some files are in need of closure with contractor certifications, which are normal procedures to this day. Please bear with us during this period. I have attached the form to confirm the one you already have, that can provide closure to this file. If I can provide other information from the job site, let us know. We appreciate your willingness to assist in this effort. And, I am available to answer any questions that arise. I appreciate working with you, as always. Yours in life and fire safety, Tom Aumock Consulting Fire Code Inspector East Jefferson Fire & Rescue ----- Original Message ----- From: Art Jones To: Michelsen, Dana Cc: Shelley Markham ; Chuck Masset ; taumock@cablespeed.com Sent: Wednesday, March 18, 2009 4:16 PM Subject: RE: FPP08-07 Clinic Fire Alarm System Dana I found the file on the fire alarm system we installed in the modular bldg. labeled as the Jefferson General Admin Bldg. A building permit was purchased for this job in August of 2004. The job was completed by October of 2004. I was there with Tom Aumock for the final inspection and test of the fire alarm system. I can fill out most of this certification, but some of the information will have to be retrieved from the job site. 3/19/2009 Page 2 of 2 This will take time to do. My question is why is this an issue after 5 years? Sincerely Art Jones Cosco Fire Protection Carlsborg Office Cell: 360-808-1649 From: Michelsen, Dana [mailto:DMICHELSEN@JGH.ORG] Sent: Wednesday, March 18, 2009 3:21 PM To: Art Jones Subject: FW: FPP08-07 Clinic Fire Alarm System From: Tom Aumock [mailto:taumock@cablespeed.com] Sent: Wednesday, March 18, 2009 1:20 PM To: Michelsen, Dana Subject: FPP08-07 Clinic Fire Alarm System Hi Dana! Here's the certification form, attached. Regards, Tom Aumock Consulting Fire Code Inspector East Jefferson Fire & Rescue 3/19/2009 i M 4. O N a) b0 ro 0 N I O C O O O N C O N O N O rn O O O O O O N N N O N N O p. O O [� - - w r a a a a a o o O C o 0 a a a a o 0 C N 1 a o N O I. N -� N CDO O O O O III O O O O O ..Z . p p p p p p p p p p p p p V w � w C � LU cG w LU LO w w w w w w w w w w w w ll F- In F- It M�F., xF- In �7ZF- 7.. in v7 N oo m cn m cn V) o V)m VI v1 oa V) oo V) oo to cn oo vl v1 0o rn [n oo rn w Lu 0 LLJ vU O w Z U a U w� � °2 7'ro , dQ wcG ua > boE ° q u 0 Da u3az w 20 z w d a a z > 0 w d' c K E cu J w a a� z3 wcU 'r o„3w, .. zE Q�Z LU �O - - 0 0 0 n. z ^..w ,. N:: ,. ..:,:•N —r^a .....—......N�._—.. _. C'•! :...., N....._ .------------ N N O O O CD O O O O O CJ O O NO N N N N N N N nl N CJ N N In ~1 1 M M 11 In 00 00 00 OC OO 00 00 CXJ 00 C#1 00 OO 00 IN Lu IN LLL tt H Z Z U z Z Z F, mJp�n : OcGmp Ocoma pn Oo;m�vp� Ov�¢rl O�nmu O Z OUCz Z Z Z�d V, cr vp p 2d n p cui C4 aN U� aUy� -�a wwiw nn wwwn >o an ww Z� mQ ruaa7 wwh° on wwwzwUn0 ��wUU, ° wwwwzwc�-O 00ww 0w00 Wuwzw0w UwUz u= �o0 w�wwaQ U� C7z x m �m f �m wpm L" s °�, mmW.m a a.�__ ... w uai �a -3vz Lo O p p � p �.._ .. p w w w w w w ¢ ¢ iW LW � cu n w w OU w 0 0 O O V) U 0 En Tun a 0 C -r 01 O a M 01 01 po po p^ p� p p cn r_n1R. w ao mo L.. mo mo mo m 0.al it ;' wcn O c c c, r r c I I Permit Query Page 2 of 2 FINAFED]LE(D;-J I J48119 �j NuUIuVV MODEL GIFT JuSM ERIDA�:00 3/24/1997u10040 ]u04/J /01+7"�LD97 SHOP STRE 00 g (000 )oHOSPDIS12 �BLD97_ 00041 FINALED ��LEG�tEFFEK50-1�v BLD CO PUBL 9483 1 8202 JIN"STALL W 1NDOW .. 834— SHERIDAN 03(24((997 00:00:00 �4/U7/1997 00 00:00 HOSP D S"I tl2 � B ID07., �'CLO �00000097 LD HSPUBL DISN112�948319202 GLASSCEFIRE SHERIDAN000007� ��COMPLEICF) �34 COMPLEFED�63LI) LN �)4831920� REPAIK/RELODLL SHLRIDAN OOOQ0109 71�010 08/:0208/:0109 9.., 001498 HOST �BLD99 003 COMPLETED LEG C J�"948319202 ��" ItLPLACL MAIN STGN� �00:00 BLD HOSIPUBI STIERIDAN��00:00:00/�� 0099 Y31. D33...084 COMPLETED B[_D JJEFT E RS COJJN YUBLICY N 948319202 --� MOVE ENTRANCE DOORS 834 SHERIDAN [04/014/1999 0:00 .. US/2I/1999 00:00:00 HEALTH . ......,_,,,,,,,,,,,,, mm... ........ ......... ,....... ....', FPP JLFFERSON FIRE ALARM 834 1 06/13/2008 D At M CO PUBL BLD08 119 SYSTEM SHERIDAN 00:00:00 �07/14/200807/17/2008 00:00:00 OU 00:00 FI HOSPDTSI'112 STREET �pl U19mmmN...�FTL � .._. LLEUGP JLFERSON HEALIHCARE4 .48321101 _ pJSEPANEW PARKING AREA 834 SHERIDAN 3/04/2005 0000LUPU 00 �03/04/2005� 00 06/10/2005 0000:00 08 ��VA PCOPUBS V I� N � ELIDAN SI 8�LUP050 00/00 0-0 m MECO1 068l C OMI'LETED '�JLEE MEC IIHOSPI 01 [4832-t--o--- I �1NSTALL BOILER 5s-1,�. 33AN� [100088:00:00 , F��00 OO 000 1'1 �00:00:000 IflLN V MEC05-004 COMPLETED MEC JI �JEFFERSON HEALTHCARE 948321002 .... TEMPORARY BOILER 834 SHERIDAN O1/IU/2005 00:0000 N]� O1/10/20U5 U0U0U0 1�_....^ [ qw° , IP04 O15 1LEG FINALED ..�:_., F GI 948321002� ..m _ ... w'AVE ........ . - OLEACE POWER ...4.4 ...�..m f SHERIDAN 00 ®0 00 4I.00:00:00 2/U4/2UU4 02/IO/2UU4 00:00:00 a 7 Ju f } USERALN PIIAL L @ . ,. �MIP05-124y EXP ED� I LIP ;; HEALIRHCAREIl J94832100�� CONSTRUCTOION 8. SHERIDAN 0 000/0005 00 .."... ." 09/12/2005 00+00:00 —_ �0000 v005 w ST CCC 044 FINeED J�MLE IS �JIELFFLER ON 948321001 ]000MIS02 ._+^ SCREEN ON OO R EDAN00:0: H 02� 00:00:00 �� 10/09/2002�[REMOVE bO li0.HOSI 'IU 2 �MI504 024 �1SSUED MIS JEFEERSON GENERAL 94832 [UO2�� DEMO ROOFINGSHERIDAN 834 00:00:00 04 00:00 0U0400:00:0004 HOSPITAL ST I F 61bi�l�;.,, _ MI504 O29 FINALED �_ __��JEF'FERSON LEG .... GENERAL 94831 20 � C'LEAR VEGE"PAT'TON SHERIDANM1S IO/0412004[10/0412004 0000OU OQ U0 10/26/2004 00:00:00 .. .... . .......... HOSPITAL SI4 _..... '`� 11ar.........��.. f MIS l------------- �X948319202� DEMO WALESNTERIOR U000U097 H PIUIST�tl2 llLO SFFRIDANIJUOOOOUtJ7LJ RC05 OO8 .� DONE m LEG ._. ;.�. �48319202 �KELOCAT'E ... FILL IPAD ERIDAN� �JS� ............ 00 ......_iEEi PRE ALN I � OO�000500 �O�U005�00 00�0005 jS''NP0''4'-04'3'- [1''lNA-LZ ]�'LSN` FA' � FRIDAN[OO�OU/0004�00/UO00 [S,3H'I4 ITHCARF�1�948319202 SIGNSMONUMCNT OOU00004 ...�HE JEFF'EKSON _....... m ............. SNP05-046 FINALED LEG- MEDICAL & New monument sign 834 10/06/2005 10/06/2005 11/03/2005 SNP PEDIA"IRTC SHERIDAN 00:00:00 00:00:00 00:00:00 GROUP 1 � SNPUB _ JEF'FCKSON ee lac S'l'p e 010... CLOSED SN„ P CO PUBL { )483 U202 wall sign withto 34 09/2008 PMT HOSP DIST #2 illuminated sign 38.75 S HERIDAN 00: 00.00 I http://permitserver:7778/forms90/PermitAttachments/html out/Permit%20Query.htm1 4/8/2009 ,Permit Query Page 1 of 2 Wednesday April M 2009 09:16 PP [ion.. A I Status pType Permit Frm RpNAocct Parent Application �. "I'll -- 11 1 11 1 11 1 - 1 Project Name �� "I'll 11- I'll 11 Street .I "I'll, 111111111-1, Submitted -11-11 Approved IssuedDt Reissue �,.....1No Type Name No Addr �0214/20 BLDOO225�.F1NALED �. LEG- BLD JEFFERS GENERAL 948319202 . ..... ROOMS XRAY ��S�HERIDAN"00�00/0000 .. 0000:000100:00:0001HOSPITA BLDO1 080 COMPLETED LEG GENERAL 948321001 REPLACEWINDOWS SHERIDANBLD L04108/2001 00 04/20/2001 00 00 00 04/24/2001 00 00 00 HOSPITALJEFFERSON ST BLD03-293 FINALED BLD �GosPRAON 948321002 FOUNDATION FOR ...__ 834 ��SHERIDAN 00:00 00300 00 00 3 00:00 0003�� _. � B93RO1- D BLD �r JEFFE GENE �HOSPITAL 948321002 BRASEISCING/SIDEWALK IC 1DEWALK� 834 SHERIDAN 07/27/2004 00:00 00 � 07/27/2004 00 00 00 08/04/20 00 00 0004� �FINALE 122 FINALED BLD A LN� 948319202 WINDOWS NEW SHERIDAN 00:00 00 41 - - 00 00/OOOS� f�BLD04 0:00 0005 H SPI �. LLL EE a BLD04- LEG JEFFERSON ,.. MECHANICAL. 834 (SHERIDAN 01/27/2005 03/24/2005 06/07/2005 lZ..m..m.__.:m 2R 1 FINALED � BLD GENERAL 948319202 ��ASBESTOS. ETC. �I.S.T 00:00 00 00 00 �.........,........�� Jlll HOSPITA.L.........� k - BLD04-237 ISSUED �i1948321002 ................. _ _ OF ��GENOERATOR 834 SHERIDAN .... .�,_O.O.00..00.......00 BLD GOSPTALN AREA 0:00:0004� 00:00:0004 00:00 0004 V, �BLD04 268��ISSUF D ��BLD GENEHOSRAL 948319202� MECHANICAL WORK 834 SHERIDAN 1001/0004 00! 0 �00 00 0004� 00 00 0010 04 � lJJJLEG• LLl �BLD04 273 �ISSUED BLD JEFFERSON HEALTHCARE ��9 p8319202 4 MONUMENT SIGNS 834 �STERIDAN 10/05/2004 00 00 I/03/10041 00 00 00 �� 1 /15/0004 00 00 00 f q %I 11IIRRII KL00 FI 4�. Il VI BLDO5 205 FINALED „ LEG- BLD JEFFERSON HEALTHCARE 948321002 CT Scanner Mobile Unit �.. Y 934 �10/] SHERIDAN 7/2005 00 00:00 10/17/2005ry 00 00 00 0:00:0005 00.00:00 1.. u1 ._ . �BLD05 216 j FINALED BLD 'JEFFERSON IHEALTHCCARE 948321001� .......... .... .... _ ...��.ST I �7 h Streetument sign at 834 SHERIDAN 10/ 00:00:0005 10/ 00 00 00 5��00 IJl 00 0005�� ..,,,. .� ial f fIEG- y IBLD05 241 , FINALED ��BLD . �If IJEFFERSON HEALTHCARE 948319302 Fire alrm system I LSHERIDANJ 00:00:000� 0:00 0005�� 0:00:0006 JEFFERSON N — — CLINICI r 34 600 BL � 6 160.tFINALED D BLD GENERAL EN 948319202� SHERIDAN 00 00 00 00 0006 00:00 0006�HOSPITAL SPCOPEDIC J LD07-170 ISSUED BLD- JEFFERSON ...._.._ 9483 ] 9202 __ .... � -- - - ��CCARE OFFICE TO URGENT _ 834 SHERIDAN 00 00 0007 �00 00:0007� 00:00 00 71 �INSTALL1 MISC HOSP DISST #2 ]8l ISSUED BLD COM- PUBL CO BLDIS 948319202 LIFTS (ER) ATICNT 834 SHERIDAN I 08/27/ 0000 0007 00 0000 7 10 00 10/0007LD07 TI # Z. _ ... _._ — -- ........ _..._ _ BLD08.j..19 C EXPIRE::... � D JEFFERSON BL CO PUBL 10] BIRTH CENTER CHANGES 834 SHERIDAN OS/20/�008 00:00 00 10/21/2008 00 00 00 1IILD MIS M1SC 1t94332 HOSP #� AVENUE . JEFFERSON ^^^^� InstallBLD- .......... ... BLD08-21„8m IS44➢I j `� CO CBL 948321101 ooms with trfts SHERIDAN 8 11/10/2008 11/10/20 8 S HOSP #2 re ai the rooms li S 00/16/20 01010 001100 Kan BS D9408- .... ....,. ... GENERAL GENERAL SON.._ ltl DITION/NEW 834 : 08/23M994 08/23/1994 = FINALED � BLD � 948321002 HELIPAD � SHERIDAN 00 00 00 � 00 00 00 HOSPITAL JI_, ST .. � 15D9503- COMPLETED LEG BLD � JEFFERSON CO PUBL II 948319202 ......,,,,w ._.. _ ...... ..._ FIRE ALARM .,...... ,,,, 834 SHERIDAN ._...._. 04/10/1995 00 00 00 04/]0/1995 �00 00 00 JI9I IIl HOSP DIST #2 11 UuIIflI ST uu BLD96 00120 D COMPLETED LEG BLD � CO PUBL .. � JEFFERSON Ills HOSP D1ST #� I 948319202I� ... J OFFICE TO EXAM ��-.... ....... ROOMS 834 1 SHERIDAN ST 08/16/1996 00 00 00 m... 08/29/1996 00 00:00 ��-� .,..... _ �OBLOD97 FINALED BLD llI...... 948319202 l STOAIRWAYp^ 11 ......l..m. 00 00 0097 000000 7 f I,LEG- DISST 42 U UI948319202 STERIDAN BLD97- �00033 COMPLETED � -HOSP CO PUBLFERSON .mm 'T-- ^^ INSTALL FOUNTAIN �.,. SHERIDAN ��ST 03/10/1997 �00.:00:00 — �-,.... µ ....... _.-.__........................ BLD —._._.:......................w....:.:....�..-... HOSP NST #2 .... ......... ...n....m..:,:,..................,m....:....................:.......�...:.................... , .. ,_..... wn....... .... ..............................W,._............-...,.,.........,:.. 00:0.0./0097 ,..................... http://permitserver: 77 7 81forms90/PennitAttachmentslhtml_out/Permit%2OQuery.html 4/8/2009 Rick Tavlor From: Donald Scott [DScott@pcs-structural.com] Sent: Wednesday, February 11, 2009 2:28 PM To: Rick Taylor Cc: Michelsen, Dana; Luke Heath Subject: Jefferson Healthcare Patient Lifts Attachments: JHC PCR--Feb.01.09--.pdf Rick, I am writing this email at the request of Ms. Dana Michelsen from the Jefferson Hospital. If you remember, I am the Structural Engineer who stamped the engineering calculations for the ceiling patient lifts that were installed in the CT Scan room and Rooms #301 through #313 and Rooms #315 through #331. I have reviewed, and am attaching to this email, the final load test reports for each of these lifts. These test reports show that the lifts were tested to twice the design (and posted) capacity without any issues noted. In our previous conversation you noted that you were concerned about the installation of the lifts because you thought that the angle braces were not installed at the proper angle. As noted in the calculations and the drawings these braces are to be installed at an angle not exceeding 2 vertical to 1 horizontal. The reason the braces are noted at a "flat" angle is to limit the tension in the connections at each end. No issues with the angle braces have been noted in the reports that I have reviewed. As I noted during our conversation we were not requiring any special inspection of the installation other than what is normally required for the load testing that was completed and is documented in the attached reports. Also as I noted during our conversation any further inspection by the city is at your discretion and not required by us. Please feel free to contact me if you have any questions concerning this issue. UIPM Structural S�,VtiCt"or' s Don Scott, S:E., Vice President, Director of Engineering tacoma 253.383.2797 seattle 206.292.5076 DScott ocs structural cs strLucturat com A N Lzi U ACCESSIBILITY SOLUTIONS 2508 Bridge Street, Victoria, BC V8T 5H3 Phone: (250)383-0405 Fax: (250)383-7099 Toll Free: 1-800-977-0721 Email: info@angelsolutions.com Website: www.angelsolutions.com PATIENT CEILING LIFT FOR EFFERSON HEALTHCARE 2nd Floor CT Scams 1CCU, MSSU, Family Mirth Center February 1, 2009 Jefferson Healthcare 834 Sheridan Avenue Port Townsend, WA 98368 T. 360-385-2200 rN 6iN Lzi 2508 Bridge Street, Victoria, BC V8T 5H3 Phone: (250)383-0405 Fax: (250)383-7099 Toll Free: 1-800-977-0721 Email: infoCp?angelsolutions.com Website: www.angelsolutions.com Service Contact and Procedures for Patient Ceiling Lift Systems Contact Numbers 1. Toll Free Office (M-F): 1 8 0-9 - 721 2. Alternate Service Pager: 250-995-9730 3. Fax: 250-383-7099 When calling for service please provide the following information and leave a brief message: • The facility's name • Your name, telephone number and time of call • Room number where the lift is located • The lift's Serial Number • A description of the lift problem At the same time please fill in the central log -book at your facility with the above details. Page 1 of 1 N G E L ACCESSIBILITY SOLUTIONS 2508 Bridge Street, Victoria, BC V8T 51-13 Phone: (250)383-0405 Fax: (250)383-7099 Toll Free: 1-800-977-0721 Email: info*angelsolufions.corn Website: www.angelsolutions.com February 1, 2009 Jefferson Healthcare 834 Sheridan St. Port Townsend, WA 98368 Dear Dana Michelsen: RE: Jefferson Healthcare - .Patient Ceiling Lift Warrant Angel Accessibility Solutions Ltd. will warranty its ceiling lift products for 1 year, parts and labour, and 1 year on batteries (pro -rated) as of date of January 12, 2009. For a period of 1 year after January 12, 2009, Angel Accessibility Solutions Ltd. will provide one preventative maintenance examination, adjustments, and parts or repairs of the equipment to keep the equipment in proper operation, except such adjustments, parts or repairs made necessary by improper use or care or any other causes beyond the control of Angel Accessibility Solutions Ltd. All work shall be performed during regular working hours, but Emergency service shall be available at all times with reimbursement for any additional overtime premium costs. 1. Subject to the exclusions set out in Clause 2, the conditions set out in Clause 3 and the limitations set out in Clause 4, Angel Accessibility Solutions Ltd., as licensed representative of Waverley Glen Systems Ltd., guarantees all equipment supplied as new against failure within the period of 1 year from date of January 12, 2009 by virtue of defects in material or workmanship. 2. This guarantee does not apply to failure attributable to normal wear and tear, damage by natural forces, user neglect or misuse or to deliberate destruction, or to hand controls more than 1 year from date of January 12, 2009, or to batteries more than 1 year from Januaryl2, 2009. 3. This guarantee shall be void if the equipment is not serviced by Angel Accessibility Solutions Ltd., or its authorized service agents in accordance with the manufacturer's recommendations or if any unauthorized person carries out works on the equipment. page 1 of 2 4. The liability of Angel Accessibility Solutions Ltd. under the terms of this guarantee shall be limited to the replacement of defective parts and in no event shall Angel Accessibility Solutions Ltd. incur liability for any consequential or unforeseeable losses. Sincerely, Angel Accessibility Solutions Ltd. Rick Silva, Project Manager page 2 of 2 1 ACCESSIBILITY SOLUTIONS 8 Bridge Street, Victoria, 04 0 . • Toll Care and Laundering of `vaverley Glen Slings Label the sling with your unit name and local. Use either a waterproof marker or request Angel Accessibility Solutions to embroider the information on the sling. • Document the serial number and date when the sling is first put in use, The company does not cover sling damage from heat, day-to-day use, and user neglect or purposeful destruction. • Inspect the sling carefully before each use. If any of the following are present or you are unsure of its safety DO NOT USE IT. Report it to your Supervisor/Manager and contact Angel Accessibility Solutions for an inspection. 1. Are the loops damaged, torn, or frayed? 2. Is there loose stitching? 3. Is there heat damage (course, puckered, or crumpled) or significant staining present? 4. Are there tears in the fabric? 5. Is there a broken buckle or closure? Laundering the slings: • Follow your unit/facility's policy and procedure of placement and delivery of sling to laundry. • The Hammock, Universal, Hygiene, Positioning and Stretcher slings are washed at a minimum of 60 degrees Celsius and a maximum of 80 degrees Celsius. Slings should be hung to air dry although drying at low (cool) temperatures for 10 — 15 minutes is acceptable. • The Standing and Walking slings should be hand washed. • Waverley Glen Systems will not cover damage to the sling if the damage occurs from ironing, bleaching and/or high heat drying. See individual sling instruction sheets for washing instructions. Washing Instructions 140" F' vfc c :�& ;E� The sling should be inserted into a washingAaunury bag prior to being p„aced into the washer, This is to prevent any unusual wear and tear of the slim by the agitator and/or other parts of the washing rnachine. 1 ACCESSIBILITY SOLUTIONS yy � N�1' I. ' 1 �X 1 P, 40. OF BEDS -4-- SYSTEM'MPE: (ebeuc ap kic" tow) GANTRY hIIFTMODES.. IM RIFT MANUF DATI : TRACK MOUMM'G Tt ): WOOD CONCRETE .. _ STEEL. FLOOR MOUNT syw RYAMpI i M. kDMAIJADANDSHCURE" bj FQ A,i AND ti' END STOPS AWMM AND TKWTENED —CHAA(MR 0WALLED AND TLT= HAND OMMOL H01 DERICUP BWALL19D GANMY b" C.:e SK UM OAMMY BOOM RUM MG TRUE LWT WAVERS NO 1" :�" I I M 1 M, 1 / E' 1 t PROPERLY SECURED ZWEIG U TESTED T a ALL PODITS ON TRACK TOMM3CVUV LRAM ~ SYSTEM 400lb(191W 4-25%-50lb(227Mlb(29'5kg) +25%- 7M lb(354,mm 450 lb (204 kph 4- 25%=563 lb (255 WE] lb ( kg) +25%lb ( W Pm Fate BY:Il'l/ FAC VA- ANGEL ACCM10EMY SDM" ONS: ( wei&Teg Rgxzt—ojwIc —t 27.07--Aac [r--W7A5 A?,$ '* DATE. 0,j � Ili" FACILITY , Room # WING NEW iNSTALI.ATION EXISTING NO. OF BEDS , SYSTEM:(chock appdic*k ems) GANTRY _AZ'TIJRNTABLE # iti3ONORAII. LWrMODEL-# �� !7 :SERIAL# TRACK MOUNTM TO- WOOD CONCRETE STEEL FLOoK MOUNT SYST M CAECSI.IST: i ti rV F i C' N'i "DPS ADJTJSTED AND TIGHTWED —CHARGMUMAWMANDTESTED ILOW GANTRY } It BOOK RUNMWGTRUE " : Y r xw m PROPERLYUNDER NO LOAD _jL,eARRY BAR. E 7! YVEIGIIT TESTFM M AU POINT (M TI i (X'M SMUMM Moo -,SYSMW WE:i' = L 400 lb ()81 kg) + 25%= so0 lb CM W 625 lb C295 l g) + 25%=781 lb (354 kg,) 450 Ib (204 kg) + 257�Fad CM kg) lb ( kg) +25%= lb ( kg) Deflection Pass INSTALLED BY: FACILHrY WITNESS: (++& &wQm*) cif" TcaRgM—Mmk—11.27.07—Aac 03 ACCESSIBILITY SOLUTIONS off SYSTJRM 4" OMNMIONING MMRT Room # NEW INSTALLA110NEXISTING • OP BIRDS __T_ SYSTEM TYPE: (dma ap wm6k Means) GANTRY TURNTABLE # MONORAI L LIST MODEL # . SERIAL # LIFT MANUF. DATE: HANDCONTROL# TRACK AMOUNTING TI ): WOOD CONCRETE STEEL z FLOOR MOUNT SYSTEM CFLECICLIST: CEtI,)'NG 8RACKPT AND GAMMY CAP SCREWS SECfJRE PAN(S) INSTALLED AND SECURE" **9AX=9QM X, Y_ INSTALLED AND SECURE** TEND SMP'S ADJUSTED AND TIGHTENED CHARGER INSYALLE) AND TESTED HAND CONTROL H01 DERICLIP INSTALLED —GANTRY WIRING SECURED GAN`IRY BOOM RUM AING TRUE _ L[Ff HEAD TRAVERS NO —UPPEWWWERIDAff CHECK TESTED UNDER NO L TAD __., CARRY BAR PROPERI M SECURED WEIGHT TESTED T b ALL POINTS ON TRACK TO SPECIFIED LMTS - SYSTEM WEIGHT T«auTS 400 lb (181 W 25% -500 lb (227 kg) 625 lb (295 kg) +25% - 781 lb (354 kg) r 450 lb (204 kg) +� 25%- 563 lb (255 k9) lb ( kg) + 25% = lb ( kg) DaSwflow P m Fal comments: INSTALLED BY: � '• � -'—" "-T- FACILITY WTIWESS: — - cj (wdgm test owy) N � Date r ANGEL ACCESSIBILM (wdsfat 6 Weight Teat Repot— Biaek —I .27.07—.doc A G ACCESSIBILITY SOLUTIONS ART DATE IU lGION FACMM .- . ROOM# WING ,„ .. NEW INSTALLATION EXISTING NO. Oil BEDS SYSTEM TYPIL.: (caoak •p dacwm also••) GWIRY --ice--- TURNTAME # bWNORAXIL LIFT MODR1.0 CONCRETE STEEL FLOOR MOUNT TRACK MOUNTING TO: WOOD M' I I C[ AND GANMY CAP SCREWS SECURE .wI ..T»i 1 :i 31 UY H • 1I DERICLIP INS17ALLED WCM RUN IING TRUE READ TRAVER&M _VjWPa"WMt LlMrrCOAX .aM)ff ) l Z/CARRY PROPWX r I I Vl • • 1 l: ►N • ^�' : 1 4t c^ Ar.rr.7lrrie+urn I► ""' +w l ... . �� +�. a M. �., a► � ,, A . s. �wal 11 ► � ANGELACCICSSMILITY SOLUTIONS: (Wcwtkodw Wd&TemRqxxt—Bhak4 27 47- 4w AkAMN ACCESSIBILITY SOLUTIONS LwrUS DAM�rd1 J �. �I �� al 7FACUM rllr "'"G.aM� w OOM# —Wilri baWIMALUMCK1 NO. OF • M01401UUL uwT moDzL.o MCK MOUNIM IN): WOOD CONCRM STM Jl — FLOUR MOUNT SYSTEM . CEUR40 HRAM rr AND CL42TMY CAP SCREWS SECURE INsrAMW AND Si: U iE" ;X RW AM SECURE•• D STOPS A=M,D AND MORTOOM �BR iNSPALLEI) AND TE IM HAM0021TROL HOI L& INSTALLED WIC WRtwo SECURED Y DWM RUNT UNG TRUE MWWERLMCMM �, rz=ySAEP�� ITS. J✓wEIGW TESTED T o ALL POEN is'Olaf TRACK To MWAM71ED' LOOM - SYSTEM WHKWr r DUM 400 lb (131 kg) t 25%— SW lb (227 kg) 625 lb (M kg) +25% . 781 lb (� 4J 450 lb (204 kg) F 25% — 563 lb kgj � lb( kg) + 2SY• a lb ( kg) Piss=,pop _ e�� A N GE L —' vi,ACCESSIBILITY SOLUTIONS • r iN a. . re) FAciury• .r "" FCGOM # <a 4) WING i r c/ - NEW INSTALLATION EXfSTING OF BEM 1 S MN "I YM. ftea hem) GANTRY _� TURNTABLE # MONORAIL LUT iL #rrttws. # _... L1FI' � DATF: �r � I L # TRACK N0'i)" i TQ: WOOD CONCRETE STEEL FLOOR MOUNT SECURE— AkWIlGHTENED ANDTWM HAM CONTROL HOLOERICLIP U46TALLED GANTRY i' E t SWURED GANTRY BOOM c TRUE EHFAD TRAVERSM LHOTCHECK ... t, DEi' Oi PROPERLY SECURED WEIGEIT TESTED TO ALL POINTS ON TRACK TO SPEMED IM&TS - SYSTEM VIEKNIT Lam I -le 400 8: (181 kg) + 25%= MO lb (227 kO .E] 625 lb (2951 g) + 25%- 781 lb (354 kg) 450 lb (204 kg) + 25%=563 55 kg) Ib ( kg) +25% 1b kg) Dcflmdolx Pass on Fell IKSTALLBII BY: FACILffY WITNFM: (►+*�ift*mA"dY). psiogNum ANGEL ACCMIBUXff SOLUTION* jr1t, WdgUT"Repact—Bluk —1127.07--aac t� AN G�-L ' 1 ACCESSIBILITY SOLUTIONS LIFT ESTEM M 1 DATE FACHM ■r� w s JII Mr wi R „1 —WING RWrALLATTox FjasTmL a>, • SYSTEM TYPE: (rAort ap di*" iW=) GANTRY TURNTABLE # MONORAIL LIFT MODEL # ? SERLAL # LIFT MMWF DATE: .-.......�.. IAA L # TRACK MOUNMG Tt ): WOOD CONCRETE STEEL Z FLOOR MOUNT SYSTEM CH.ECKLIBT: Au CMG SPACKI'ST ARID GANTRY CAP SCREWS SI C"M li ', INSTAUJWANDSECUitE*• INSTALLED AND SECURE+• END SMPS ADJUSn' ) AND MGHT'ENED —CHARGER DUrALLED AND TESTED HAND CONTROL R01 DEYi&IM INSTALLED _ GANTRY WMING SEC URED GANTRY 1300M RUN] UNG TRUE _ LIFT HEAD TRAVERS NG UPPERALOWER LIMIT CHECK D UNDF NO L 3AD CARRY'BA,R PROPE� .Y SECURED IGHT TEWW T 0 ALL PORM ON TRACK TO SPECZqED LD& TS - SYSTEM WEIGHT Lmm 400 lb (181 kg) i• 25%-5001 (227 kg) 625 lb (295 k) +25%- 781 lb (3M ko 450 Ib (204 kg) V 25Yo : W I (255 W lb ( kg) + 25% = lb El DefieWom P uss EZfFail Commants: INSTALLED BY: F"ACMLITY W rNESS: (wdgh wtonly) ANGEL ACCESSIBE 1 Y SOuL1P1['IONS: (wew ms" Woi& Tat Roport- Slink -I .27.07--.dw 7, ACCESSIBILITY SOLUTIONS DATE L�? ` REGION Plld ' FACIIITY a,�t ROOM # Q WING Q NEW INSTALLATION _ EXIS n NG NO.OF REDS SYS rRM TYPE: (cbcck ap diodAe i m) GANTRY TURNTABLE # MONORAIL LIFT MODEL # v Q SERIAL # LIFT' MANUF. DATE: IIANDCONTROL # TRACK MOOING IN): WOOD CONCRETE STEEL FLOOR MOUNT Comments: Sg/k,CEMJNG EM CIIFdC�rIS'I": BRACK) iT AND GA %rMY CAP SCREWS SECURE INSTAi I m AND SECURE** ;X DWALLED AND SECtW** END MPS ADJIUMs) AND TIGHTENED �Z— CHARGER INSTALLED AND TESTED HAND CONTROL HOI, DERICLIP INSTALLED _ GANTRY WIRING SECURED GANTRY BOOM RUNS DING TRUE LIFT HEAD TRAVERS NG Wi CHECK Y NDER NO L )AD RPROPERI .Y SECURED Wf TESTED 7 D ALL PORM ON TRACK TO SPECIFIED 13AUTS - SYSTEM WEIGHT LibuTs 1100 400 lb (191 kg) i- 25% - $00 lb (227 kg) 625 lb (295 kg) + 25a/e - 781 lb (354 kg) 450 kb (204 kg) r- 2514/c - 563 lb CM kg) lb ( kg) + 25% = lb ( kg) Defladdow P lss FaB INSTALLED BY: FACELITY Wcr?sS: (weidm w fir) ANGEL ACCESSIBILr fY SOLUTIONS: (waoAftsew ware Test PApW — Bldc —1 .27.07-- dac _ram cam e Dery A r\l (13E L ACCESSIBILITY SOLUTIONS DATE RI''GION D +,9kJAA9&1) FACILITY ROOM # , ©� WING i S 5 I% NEW INSTALLATION _ EXISTING NO. OF BEDS SYS"'I ZM TYPE: (dw* ap Ni�hie bo=) GANTRY TURNTABLE # MONORAM LIFT MODEL # -7.-3 30061 SERIAL # LIGHT INIANUF. DATE: IJANDCOMMOL # TRACK MO INC 1): WOOD CONCRETE STEEL FLOOR MOUNT SYSTEM C A ( CEILING DRACKHM AND GANTRY C" SCREWS SECURE "** r1B1°b5�9iMM MSTAND SECURE** " MgMM; �'TALLED ANC) SECURE** ,,�,,'E;! STOPS P AND TCGHCENFD _ CHARGER 24STALLED AND TESTED _ HAND CONTROL HOL DERICLlP INSTALLED —GANTRY VMUNG SECURED _ GANTRY BC)OM RUM 41NG TRUE M HEAD TRAVFM NG CHECK �8MD UNDER NO L JAD _teCARRY BAR PR .Y SECURED WEIGHT TESTED T O ALL POINTS ON TRACK TO SPECIFIED LBUTS - SYSTEM WEIGHT LIMITS 400 lb (181 kg) +- 25% a 500 lb (227 kg) 625 lb (295 kg) + 25% = 781 lb (354 kg) 450 lb (204 kg) v 25% = 563 lb (255 kg) _ lb ( kg) + 25% = lb ( kg) D+eflecdwa: P 3ss Fail INSTALLED BY: FA,CILM WITNESS: (wciglt tcst 0*) ANGEL ACCEMMILF PY SOLUTIONS: (Wdotbmdw W*Wd Tcst RgxM—Blank —1 27.(rA—.aoc /-i-o9-. �-� - DW iA�SSIBILITLDU EONS @ Q l i u i O " f f 1 1 ! NO.OF BEDS vM TYPE: (ce.et.p aieiie ft=) C3AMMY TURMABLB # MONORAII.. V LIF1.' MODItT..# gRlRl[A3 # LIFT 1VIAKM DATE: Eupu>cNDmTRoL# TRACK ,11 C �`I TO: WOOD C , STEl:I. FLOOR MOUNT SYSTEM. I'T. 1 0 ALL M' I 1 t BRACM.TrAM GAMMY CAP SC: SECUM 'y:M,ta.,. Y„11 R:f".1 lftTALLM AM t EMMPsAb .I ry. 1 _ li yi Ni CKNORM HOI OeRAMPRMALLM —Gwmywmm<lmcupjaD OANMY :11 ]NO TRUE 1Uff HEAD a' t —up. " t „o I .I M f. N' 1 UNDER NO L 3AD CARRY BAR PROPM,Y SECURED zwmaur TERM TD ALL PORM ON TRACK TO - SYS'11M WEIGHT IMM 400lb (181 kg) t• 25%-So lb (=7 kg) 625 >b (295 kg) +25-A-781 lb (354 kZ) t�f450lib (204 kg) i• 25%=50 lb CM W lb ( kg) +25%� Ib ( kg) P w Fan Comments: INST BY: FACHM VffrNM (+me*) ANGEL ACC LLP f'Y So,,,�L,,1WTlo ,�F,�7,,�w�- W TcA Rq=t- Bbak -1 27 07—Aac A'CCESSIBILIGoE IL LWr §YSTEMMR DATE 0//`�� RI:LION <Afl r) FACILITY -rr /&�e; ROOM # / (3 _ WING NEW INSTALLATION EXISTING NO.OF BEDS SYSTEM TYPE: (dbock.p diewc tams) GANTRY TURNTABLE # MONORAIL LIFE' MODEL # SERIAL # LIFT bt&NM. DATE: MANDCONTR+OL # TRACK IOUNTIN'O 'n ): WOOD CONCRETE STEEL IZ FLOOR MOUNT SYSTEM CHECKLIST: CEiLRdG SItACKI i, r AND GANTRY CAP SCREWS SECURE INSI'ALLED AND SECURE** t INSTALLED AND SECURE" AD N ) AND TIGHTENED CHARGER INSTALLED AND TESTED HAND CONTROL HOL DERACLT INSTALLED _T GANTRY WIRING SE(URED GANTRY BOOM RUN] ONG TRUE _ LIFT HEAD TRAVERS NG UPPERILOWER LBOT CHECK _'%ESMD UNDERNO L::)AD CARRY BAR ROPERf M SECURED je�WEIGHT TESTED T D ALL POINTS ON TRACK TO SPECIFIED LIMITS - SYSTEM WEIGHT LRATS 400 lb (I81 kg) } 25% — 5N m (=7 kg) 625 lb (295 kg) + 256A =181 [b (354 kg) 450 lb (204 kg) } 250% = 50 m (255 kg) lb ( kg) + 25%= lb ( kg) Eg Deflection: P ass 06 FaR Comm: INSTALLED BY: FACIIXrY WITNESS: (weiNm w odr) ANGEL ACCESSIBELF SOLUTIONS: (Wd&bt Wd#d T4W Raport-8tank —1 27.m .aoo G�p A N G E L ACCESSIBILITY SOLUTIONS la�Z-1 Lam" aYSTEM ING RFRQRT, DATEWRI1,010N FACILITY �5Zvr"i5d " ROOM # WING .r7) NEW INSTALLATION MST]NG NO. OF BEDS SYSTEM TYPE: (cheek W3,Ij && ) GANTRY TURNTABLE # MONORAIL __ZZ LIFT MODEL # LIFT hL4NUF. DATE: SERIAL # t t � TRACK MOU NTI NG To: WOOD CONCRETE - STEEL FLOOR MOUNT Ceaala: SYSTEM CHECKLIST: CEILING MACK T AND GANTRY CAP SCREWS SECURE P INSTALLED AND SECURErr t INSTALLED AMID SECURE" STOPS ADIUSTE �? AND TIGHTENED CHARGER iNS1 ALLE1, AND TESTED _ HAND CONTROL IIf)I DERJCLIP INSTALLED GANTRY WIRING SE(,bRED _ GANTRY BOOM RI1"4 ING 'TRUE LIFT HEAD'7RAVERSING —Uppa"WERLWTICHECK MM UNDER NO 6,6 CARRY BAR PROPER[.Y SECURED WEIGHT TESTED TO ALL POINTS ON TRACK TO SpECUqED L11V17ITs - SYSTEM WEIGHT LIMITS 400 lb (181 kg) 25% = SON lb (TV kg) 625 lb (295 kg) + 25% = 731 lb (354 kg) 450 lb (204 kg) } 25% = 563 (255 kg) lb ( kg) + 25% = lb ( kg) Deflection: Piss Fart Comments: INSTALLED BY: FACILITY WITNESS: (wdgt test only) ANGEL ACCESSIBILI'!f SOLUTIONS: (wet Weight Test Rqpott—Black —1 .27.07—.dw 11-2-107- Bz- ANGEL ACCESSIBILITY SOLUTIONS LWf SXSTFM COMMMIONING REPORT )-,An FACILI[TY Ploom # NEW INSrALLA110N EmSTm NO. OF HIN3S i SYST'EM TYPE: (&Atk vph,:m* ft=) GANTRY TURNTABLE MONORAIL DLO SERIAL# LUrr MANUR DATE: 11ANDCOMMOLN TRACK t4OUNITiG TO: WOOD cowcRm STEEL FLOOR MOUNT LWMLV�L Ko for"A&ll 19 r*CTsS.[1HG 11R�ACKET AND GANTRY CAP SMW SECURE RWALLED AND SECURE** fignALLEDANID SECURE** END STIOPS ADJUSTED AND TIGEnENED CHARGER DWALLED AND TESTED —MOID CONTROL EK)LDERICLE? DWALLED GANTRY WRING SECURED GANTRY BOOM REMNING TRUE —lJFrFEADTRAVERMM UPPRItALOWER LOW CHECK TESTFM UNDER NO LOAD CARRY BAR PROPERLY SECURED AZWE*r.HT TESTED TO ALL POINTS ON WACK TO SPEMM LOEB - S"nM WEMIff LM" 400 lb (131 kg) + 25% — -"0 lb (227 W H 625 lb (295 kg) + 25% — 781 lb (35i kg) 450 lb (204 kg) + 25% — lb (25� kg) lb kg) + 25% lb kg) Rl� Deflwdottz Pm 7IFag = INSTALt", BY: FACILITY VArTT4M-. (waWamady). ANGEL ACCESSIBUATY SOLUTION& *"& ustbw Wd*TblRZpolt-Hbmk -11.27.07--Aae m us � A'A SNLITSOLUTIONS I �I(INIQ ts"O, 1 DATE �s Ri :GION • 1:6 ►� . ,� FACILITY ROOM # ] WING A4 555 NEW INSTALLATION maSTING NO.OF BEDS SYSTEM TYPE: (cbcckap Piwo a ftm) GANTRY TURNTABLE # MONORAIL LIFT MODEL # _ SERIAL # rp i l 3 p3 S LEFT MANUF. DATE: q 19,5? HANIWONTROL # TRACK MOOING TI ): WOOD CONCRETE STEEL, ,� FLOOR MOUNT SYSTEM CHECIGUST: CEILiNCi BRACKJ T AND [DAJWMY CAP SCREWS SE(4JRE fRM INSTALLED AND SECURE** .Y INSTALLED AND SECMO* END STCDPS ADJUSTI?M l AND TIGHTENED CHARGER RarALLED AND TESTED ELAND CONTROL HOl D6>;XU P INSTALLED GANTRY WIRING SEC URED GANTRY BOOM RUN] UNG TRUE LIFT HEAD TRAVERS NG �LWT CHECK —L,-IESTED UNDERNO LIAD CARRY BAR PROPERLY SECURED ]WEIGHT TESTED T D ALL POINT'S ON TRACK TO SPECS LIMITS - SYSTEM WEIGHT LIMITS 400 lb (Isl k) 25% s 500 lb (227 kg) 625 lb (295 kg)+ 25%= 781 lb (35 1 kg) k€J Ib (2s5 IW lb ( � + 25% s lb ( �J ES: D . P FaB INSTALLED BY: EACH ff WITNESS: (wctgonly) ANGEL ACCESSIBIL PY SOLUTIONS: (w d& W0 Tv9R Pwt-BlmrLk -f .27.07--.doc [��7ACCESSIBILITY SOLUTIONS LWI'S-fTES �NING REPORT DA'T11 AI� FACILITY RFdiiQN ROOM # WING INSTALLATM MSTiNG NO.OF BMS SYSrM TY : ww* voxwc ems) GANTRY TURNTAUE # MONORAM LIF£ MODEL # SERIAL # LIFT . DATE -- TRACK MOUNTM TO: WOOD CONCRETE STEEL FLOOR MOUNT ,,{ I,r `�lM. a�. � Gar •� y:. — ��.�b" 1 c• I WEIGHT TESTED TO ALL PMI IS ON TRACK TO SPECIFIED UI►4i•IS - SYSTEM WEIGHT LOAM 400 !b (18I kg)+ 25V.= 5W Ib (227 kg) 625 Ib (295 kg) + 25%a781 Ib (354 kg) 450 Ib (204 kg)+ 25%—W lb CM kg) Ib 4 kg) +25°Y. m Ib E9 Def ectiow Pass ad = INSTALLED BY: FACILITY VArENESS: (wdd ba ady)• ANGEL A M SOLUTHM& ( WTiWRq"-1 b&t—1127.07 Aw 77, AM Elk t ACCESSIBILITY SOLUTIONS LUFf SYS11MCOMMSSIONING REPORT den DATE 1tEGiON FAcmrrY kO0M # WING W IMALLATION EXISTING NO. OF BEDS j SYMN " Vft: (dxok awwaw 1tm) GANTRY ZnMNTABLE # MON SF.BIA.L # Ldlii` MANUF, DlL'I"E_ lLkNocotfmoLs TRACK MOUNTING TO: WOO© CONC MM STEEL FLUOR MOUNT C WEIGHT TESTED TO ALL POINTS ON TRACK TO SPECII M IMAM - SYSTEM WEIGHT I MFI'S 400 lb (181 kg) + 25%= NO b (227 W 625 lb (295 kg) + 25%- 781 b (354 kg) 450 lb (204 kg) + 25% =50 b (755 kg) tj Ib ( kg) +25%— 1b ( kg) 15 Pass F-V-1 Fad LNgrALLM BY: FACILPI'Y WITNESS: ( ftm odr), ANGEL ACCMUMLITY SOLUTIONS: (wcwkAhw W . TedRq mt-Blot -1117.07=Afac I ACCESSIBILITY DATE Room # NO, OF RIDS --I- - SYSTEM TYPE: (cbo& ap Ai I WE dams) GANTRY TURNTABLE #' MONORAIL LIFT MODEL # SRRUL # LJFT MANIU . DA"TZ: HANOMMMOL # TUCK MOMMG 70: WOOD CONCRETE STUL FLOOR MOUNT SY M xlj w" ; CEDING BRACIUs r AND GANMY CAP SCREWS SECURE MrAM OMALLD AND SECURE-- IN�A AND SECURE** kEND MPS ADJUSTEP AND 1i( TCENIrD _ CHARGM INS[AL Ud) AND TIMM BAND CONTROL NOI CWJtACLIP HiSTALLED GANTRY WIRING SE( URED GANTRY BOOM RUM 4ING TRUE LIFT HEAD TRAVERS NO —LTPPERWWERLMPCHECK TESTED UNiDER NO L )AD a CARRY BAR PROPERLY SECURED ZWMC.W TEST® T O ALL POINTS ON TI?tAm To mmcu ED umm - S"YS"ILM WEtGnT I IIiI�'TS 400 Ib (1 EI W F 25%— W lb (227 kg) 625 lb (295 kg) + 25% 781 lb (354 IW 450 lb (204 kg) F 25%- 563 lb (255. kg) LJ lb ( kg) 25% d lb ( kg) DI Piss Fafl Comments: MTALLM BY: FATTY WTSS (vraift w only) ANGEL ACCMtj3ELr PY SOLUTIONS: (mc+dd - 11 8) WOWTedRmpm-Btk-i .27.07—aa rAl r4 IANGEL ACCESSIBILITY SOLUTIONS WT SYSTEM IDWAMIONING DATE REGION FACHM, :G NEW INSrALLATION WaSTING NO. OF BEDS SYSTEM TYPE: (chwk ap )[icdAc ions) GANTRY TURNTABLE # MONORAIL LYFI' MODEL # LIFT' MANIA`» DATE: CFRL4L # TRACK MI UNTING T(): WOOD CONCRETE STEEL FLOOR MOUNT C ts: SYSI' m CHEACKIA : CE[LING BRACiCI IT AND GAAMMY CAP SCREWS SECURE * INSTALLED AND SECURE" INSTALLED AND SECURE** AND nGHIENED _ CHARGER INS'TALLE]) AND TESTED _ HAND CONTROL HOI DERICL P INSTALLED _ GANTRY VAM240 SEC URED _ GANTRY BOOM Rt N] 41NG TRUE _ LIFT HEAD TRAVERS NG UPPER.WWEk LBOT CHECK TESTED UNDER NO L )AD -_, (:WY BAR PROPERLY SECURED WEIGHT TESTED T D ALL POINTS ON 'CRACK TO SPECEIED L NCTS - SYSTEM WEIGHT L hG TS 400 lb (181 kg) } 25% = 5001b (217 kg) 6251b (295 kg) + 25% = 791 lb (354 kg,) 450 lb (204 kg) i- 25%xFaa (2a kg) lb ( + 25% = lb ( kg) I Pm , commen": INSTALLED BY: F'ACILM V'ITSS: (weigid+Aady) ANGEL ACCESS'Imu, rY SOLUTIONS: (Wdotusdw Wci& Teat Rapmt— dank —I ".07—.doo ACCESSIBILITY IL DAT4A4—ZqffFACIIM OM #wmc. NEWINSTALLATIONEXISTING NO. OF m2l= a/ SYSTEM TYPE: (ebert pp Nimble iam,) GANTRY TURNTABLE # MONORAIL LIFT MODEL # SFSJAr. # Lff MANUF DATE: IiIANDCOv L # TRACK MOUNTING P ): WOOD CONCRETE STEEL 1,/ FLOOR MOUNT ' SYSTEM CHECKLIST: A LL CEQ IN(3 ARAQU iT AND CiA%Fi RY CAP SCREWS SECURE jrPM IN.SCAT l srn AND SECURE«* I, AND SECURE** END STOPS ADS,J I) AND 11GHTENED CHARGER RMA.LLED AND TESTED HAND CONTROL HOI DER>iCLIP INSTALLED _ GANTRY WIRING SEC URED GANTRY BOOM RUN) J1NG TRUE LIFT HEAD TRAVERS NG u" wm L11iAPT CHECK TESTED UNDER NO L )AD CARRY BAR PROPERI .Y SECURED VWWGHT TESTED T D ALL POINTS ON TRACK TO SPECWIED L DMTS - SYSTEM WEIGHT LMrfS 4001b (181 kg) +• 2SOA = SOO Ib (XV kg) 625 lb (295 kg) + 25% = 791 lb (354 kg) 450 lb (204 kg) 4- 25% = S631b (255 kg) lb ( kg) + 25%= lb ( kg) El Defir pas GZ� Fail INSTALLED BY: FACilLrJrY WITNESS: (weight w «dy) ANGEL ACCESSIBILI' fY SOLUTIONS: (wci& k WaW Trot Repot-- 04nk —1 .27.07 .dw ��ANGEL ACCESSIBILITY SOLUTIONS lmr_SY8TEMCQN[�.Wl0NNG DATE Ri'sGION ,° FACIIITY ROOM # _ G NEW INSTALLATION EXISTING NO. OF BEDS SYSTEM TYPE: (dick op direie clams) GANTRY TZJRNTABL E # MONORAIL LIFT MODEL # SERIAL # LIFT b ANU DATE: HANDCONTROL # Tit A fV Mir11lNTtNir- Tt )! WOOD CONCRETE SIT.& �� FLOOR MOUNT co SYSTEM C LIS'T: C EUJN 3 BRACYJ SST AND GAMMY CAP SCREWS SECURE MM INSTALLED A14D SECURE** WSTALLED AND SECURE** ) AND TIGi•iT04ED _ CHARGER INSTALLED AND TESTED HAND CONTROL HOL DFJWL.1P INSTALLED GANTRY WIRING SECURED GANTRY BOOM RUM LING TRUE LIFT HEAD TRAVERS -NO UPPERILOWERLiMff CHECK i TESTED UNDER. NO L aAD CARRY BAR PROPERLY SECURED WEIGHT TESTED 7 D ALL, POINTS ON "TRACK TO SPECIFIED LVAM - SYSTEM WEIGHT LTMTT6 400 lb (181 kg) } 25% a 500 lb (2V kg) 625 lb (295 W + 25% — 791 lb (354 kg) 450 lb (204 kg) i- 25% = 563 kg) lb ( kg) + 25%= ib ( kg) Detiec:6on: P ins Fail 10 7 INSTALLED BY: FACILITY WITNESS: (wei& test owy) ANGEL ACCESSIBEEXIrY SOLUTIONS: (13 W* deTaetRepat—Bl=* —1 .27.07 —.doo jq„,� .� " i WON ANGEL ACCESSIBILITY SOLUTIONS DATE / D 9 REGION � . � � FACILITY �'`" Room* 3) WINGCNEW INSTALLATION EXISTING NO. OF BEDS SYSTEM TYPE: (dbb* ap )liable hems) GANTRY TURNTABLE # MONORAIL LIFT MODEL #� SERIAL # LEFT MANUF. DATE: it ' HANOCONTROL # TRACK MOUNTINO M: WOOD - --- -- CONCRETE STEEL _� F"R MOUNT SY�"' ,M CIMC1 XW; CEILING BRACKl3T AND GANTRY CAP SCREWS SECURE •MMSA PM 1g INSTAT M AND SECURE** • jX INSTALLED AND SECURE" END STOPS ADJUSn-17 AND TIGHTENED _ CHARGER INSTALLED AND TESTED _ HAND CONTROL HOT. DERICiiP INSTALLED _ GANTRY WIRING SEC URED GANTRY BOOM RUN] 4ING TRUE LIFT HEAD TRAVERS NG UPPERILOWERLMT CHECK TEUNDER NO L 3AD TSTED CARRY BAR PROPERLY SECURED WEIGHT TESTED T D ALL POINTS ON TRACK TO SPECIFMD L UTS - SYSTEM WEIGHT Lmmp �r 400 lb (181 Its) } 25% 500 lb (227 kg) H625 lb (295 kg) + 250A = 781 Ib (354 kg) 45016 (204 kg) h 25% - 50 Ib"kg) lb ( kg) + 25% = lb( kg) Deli ` . P Iss oZ }?an= INSTALLED BY: I ACC VA TNESS: (waigb imt 09y) vU � ANGEL , CCE M1 Y SOLUTIONS:7,1,4VI (W68MUSdrAID WoW Tat i "Mt- Blank -1 27.07—.aoc 1-7-,&q Date 1-7-O' ANC3EL ACCESSIBILITY SOLUTIONS LW SYSTM COMMMIONMG REPORT DATE .1- MIGION FACILITY ROOM # — WING EXISTING NO. OF BEDS SYSTI�M TPYPE: (urx# sp �iobie Yems) CLAMMY TU NTABLB # MONORAIL LII r MODEL # SERIAL it LET MANUF. DATE: VvjqacONm0L # TRACK MOUNM G In): WOOD CONCRETE STEEL FLOOR MOUNT SY�S EM �T CEC �UMANG BRACK:I iT AND GArFMY CAI! SCREWS SECURE * ME MEM roM INSTALLED ED AND SECURE** rG INSTALLED AND SECL%E*• _ END STOPS ADJUSTEo AND *nGH1ENED —CHARGER INSTALLED AND TESTED HAND COONIROL HOI DERA31P INSTALLED GANTRY WO NG SEC URED _ GANTRY BOOM RUM LING 'TRUE _ M BEAD TRAVM NG _UPPERWWR LMT CHBCK _'TESTED UNDER NO LEAD CARRY BAR PROPERLY SECURED WEIGHT TESTED T D ALL PODM ON TRACK TO SAD LIMITS - SYSTEM WEIGHT LIMITS 400 lb (181 W 1- 25% - SW lb (221 kg) = 625 lb (295 kg) + 25% - 781 lb (354 W 450 b (204 kg) 4- 25% - So lb (255 kg) lb ( kg) + 25%- lb ( kg) Deflactiom Piss Fat r � rp FACILITY wrrNESS: test **) ANGEL ACCBSSIBTli.1' SOLUTIONS: (vjdlK wtft Trat Rapwt— Bunk —I .27.07— dot G 1 ACCESSIBILITY SOLUTIONS'-_ DAM . W- ' 4 r rw r�Mi��NEWINSTALLATION :X ISMG a ■ SYSTEM TYPE: (cbcck ap Nimble b) GANTRY 4/_ TURNTABLE # MONORAIL LIST MODEL # SERIAL # LIlff MANUF. 'DATE: . � � _ � HANDCONI kOL, # TRACK MO T<): WOOD CONCRETE STEEL_ FLOORMOUNT SYST'EMCRECKLM CEILING WUC=rrAID GANTRY OAP SCRJ8WS SECURE R4�' AND " �c INSTALLED AND SECURE" 5 WD ESTOPS ADJUSTED � AND TIGHTENED WSTALLE) AND TFS'IED CONTROL HOI DERICLIP INSTALLED WIRING SEC URED GANTRY BOOM RUM KING TRUE vTRAVERS NG CHECK y DER NO L 3AD R PROPERf .Y SECURED lz�ew TESTED T O ALL POINTS ON TRJUX TO SPECIFIED LIMITS - SYSTEM WEIGHT LRAM 1.10 4001b (181 kg) .r 25% — 500 b (Z27 k8) = 625 Ib (2" k 25-A = 181 lb (354 k@J 450 lb (204 kg) } 25% 563 lb ($55k9) lb ( W' + 25% w lb ( k$J Deflaction. P iss Faa Comments: MTALLED BY: 'ACiIM WITNESS: (weight ttat only) ANGEL ACCLSSIBUif fY SOLUTIONS: (_d&WS609) Weight Test Repot— Bbnk —1 .27.07—.doc wA A ^� A N G E L 1 ACCESSIBILITY 50LUT10 $ DATE(1(Ilk FACILrTYW" .. ROOM # WING p �,�LXEW INSTALLATION maSTING NO. OF BEDS SYSTEM TYPE: (chesp -Aimwa boom) GANTRY z TURNTABLE # MONORAIL ats . LIFT MODEL # �� I 1 - L # .� AMWW OL # LiFf M'�F. DATE: 1 1 1 . 1 1 1' • e SYSTEM SST: CEILING BRACXQYT AND GANMY CAP SCREWS SECURE * 11MALLED AND SECURE" *L-II'�TS1'ALL� AND SECURE+• STOPSA151'C�SMI,) AND nGHTENED tR INSTALLED AND TESTED CONntOL HOI Dmudm INSTALLED 5f W RMO SEC URED G BOOM RUNT ZING TRUE T CHECK AD CARRY SAS PR S.Y SECURED WEIGHT TESTED T O ALL POINTS ON TRACK TO SPECWEID LDWM - SYSTEM WEIGHT 400 lb (131 W .H 25% — 500 lb (zr, ka) 6?S lb (2951� + 25°rL = 781 lb (3541cg� 450 lb (204 kg) 1- 25% = 5631b lb( W + 25V. _ lb( W Defladim- P iss Fa17 INSTALLED BY: FACILITY W ESS: ( tcstedy) ANGEL ACCESSMITY SOLUTION'S: (Wowbmtbw O.arrwrrw.'^Yw�n'"1' Jtslw:'!!:. 09016, , Wah t Test RepW —' —1 2797--Aoc ACCESSIBILITY SOLUTIONS p 1 1 DAM /"emsMMONMaUff .° '�� 57w ,O` M, DID 1 NO.OF BEDS I_ SYS['EM ?I[PE: (efieot ap Nie�le ilprs) GANTRY TURNTABLE # MONORAIL Lter MODEL. # L, # Uff MMWUV 'PAI furmccowtoum ITACK MOUNMG 1 ): WOOD C ONCU"I"l ' - STEEL FLOOR MOUNT sYSTCM CHzcN . ,�.�, c>�n�a Bzewcxi srAm oAxr�Y c p sews sECURE ■ 1NSTALIM wrro sa• + INSTA[d ED AND SSC[iRE'* _ c R nlsrALLM) AND ITSM HAND CONTROL H01 ENgt/CXJfP INSTALLED ( AWMY VIUM40 S' GANTRY BOOM RUM UNG TRUE LR+T HEAD TRAVERS :.WG U LIMrT CHEC K —TESTED UNDERNO L3AD CARRY BAR PROPERJ,Y SECURED _�/oNEGM 7MED ID ALL POOM ON TRACK TO SPECIPM LOAM - SY" M WEIiIH'i' LRIM 400lb (181 1-2r 500lb (227 IW G25 lb CM kg) +25%-` 91 m (354 kg) 4501(204 kg) * 25% 563 lb CM ks)R lb ( kg) +25'K = Ib ( kg) Ier - Piss I -H PACE (w+tody) ANGEL ACCESSOMM SOLD cmd&Uwgkw weWtTmRqmt -i 27-07—aoo (s 71 DATE�" �. bGION FAaLrlY ROOIl1+[3a,c � WING � � NEWINSTALLATION -/— EXISTING NO.OF BEDS SYS'X' TYPE: (dw* ap diombl br ) GANTRY TURNTABLE # MONORAM 1� LiFr MODEL # SERXAL # LOT bU NM DATE: HANDCONTROL # T>Acx IR r. WOOD CONCKM sTM 4,,,-� FLOOR MOUNT WW CHECK "—TESMUNDERNO LEAD CARRY BAR PROKM.Y SECURED —/,WE WAff 7WMT D AM PO ON TRACK TO MQ5lLiNIl7 "S18M WEGI3T 4501b (204 kg) 25% = 563 k (255 kg) lb( W 25% lb ( kg) P ms J F.0 IN'�ALLIND BY: FACHMVA.. (tcdody) FIL'114',Aff,'It 'iN �JMX w 'fain: Repot- -1 Tl m— 6w 4 7 ANG e ��, I ACCESSIBILITY SOLUTIONS Qxf H WSJQNING REPORT DATE REGION W « r�r �. v *OM# WING NEWaiSTALLATMEXISTERd O OF D. SYMM 'TYPE: uhe* eMkabk ilcm) GANTRY TURNTABLE # MOT : LEFT DATE: ILANDCONTROL& TRACK MOUNTlNG TO: WOOD CONCRETE STEEL FLOUR MOUNT SYSTEM CI%ICI LWF: CCEMG BRACKET AND GANTRY CAP SCREWS SECURE RW, AND SBCURE# MA Y STA[LED AND SECURE" -.. ENO STOP$ ADJUSTED AND 11(m ENED _ CHARGER UWALLED AND TINTED HAND C(TTIROL EK)LDERMLIP DWALLED _ GANTRY WIRING SECURED GANTRY BOOM RUNNMG'IRUE LIFT HEAD TRAVERSM _'iES W UNDERNO LOAD CARRY EAR PROPERLY SECURED ZWEIGHT TESTED TU ALL POINTS ON TRACK TO SPEMED LiIM'S - SYS"i'EM WEICHIT LIIIM 400 lb (181 kg) +23%= SW lb (227kg) , 625 Ib (245Icg) + 25%— 7311(354 kg) 1 450 lb (204 kg) + 24'A = 50 & (255 kg) lb ( kg) +25Y. — Tp { kg) Defkedon: Pass ff6 Fad BALLED BY: FACILITY WITNESS: (md-Ly) ANGEL AC.CESSmi SOLUTION& i WeiodTeatRmW—Bunk—1127.07—Ax I i _IiA N G ACCESSIBILITY SOLUTIONS REPORT DATE L;L2� REGlON FACILITY • r , s OF BEDS SYSMM TY : fao& vptKabk hem) GANTRY 'TURNTABLE # MONORAIL _ jj,,-' LRT DEL # SEIHAI, # L WT MAMM. DATF:: I L # TRACK MOUNTMTO: WOOD CONCRETE STEEL FLOOR MOiRQT C CE1L NG BRACKET AND GAMMY CAP SCREWS SECURE II+PS'i'ALL TkD AND SELCURE** OWALLED AND SECURE** —END STOPS ADJUSTED ANI)1liffPfENEU __.. CHARGER R4SI'ALLED AND TESTED —HAND CONTROL EKNMERICLIP U49TALJM _ GANTRY WDUTNG SECURED —GANTRY BOOM RUNNING TRUE LIFT FADIRAVERSR3C _UPPERWWERLBWCHEXX _'TESTED UNDERNO LOAD ,CARRY BAR PROPERLY SBCURM Ae EIGHT TESTED TO ALL POOM ON TRACK TO SPEaFJED LOAM - SYSMV WEIGHT LD&TS 400 lb (IM kg)+25%-M b (227 kZ) 625 lb (295 Jcg) +25A a731 lb(354 kg) - 450 b QG4 kg) + 25% - 50 lb55 kg) R) ( kg) ' 25% lb ( kg) Dalecdon: Pass =1 Fad i STALLS BY: FACILITY 'vvrrNFM.. (wa+im ow aQw ANGEL AC�IfBLLITY SOLUTHMS: ( W. TeARepcft-8lftk —11.27.07=Aoa o9 ACCESSIBILITY SOLUTIONS DATE I REGION 4FACILITY ROOM # ], 4 WING All &L�' - NEW INSTALLATM _ IsXI MG NO. OF BEDS_ SYSR RM TYPE: (dW* ap ►liaifaa bW ) GANTRY 71IRNTASLE # MONORAIL LOT MODEL # �j C� 3 ©('1 f7 SERIAL # "�p) ] 9 LET MANUF. DATE: HANDCONTROL# TRACK MOUNTING IN): WOOD CONCRETE STEEL FLOOR MOUNT SYSTEM ICLISL": �� 1 Ml r CEMJNG BRACKI sT AND GANTRY CAP SCREWS SECURE �' " INSTALLED AND SECURE"IAAMMM ,_Y INSTALLED AND SECLME** END 'TOR" S ADJUSTS- 0 AND T[GMTEIVED CHARGER. INSTALLED AND TESIFD HAND OONTROL HOT DER&'LIP INSTALLED _ GANTRY WRING SEC URBD _ GANTRY BOOM RUM LING TRUE _ LIFT HEAD TRAVERS NG —UPPERWWERLMTCHBCK 'TESTED UNDER NO L?AD __ CARRY BAR PRCiT" '.Y SECURED WEIGHT TESTED T D ALL POINTS ON TRACK TO SPECHMM LD IITS - SYSTEM WEIGHT L, 400 lb (181 kg) 25% — 5001b (227 kg) 625 lb (295 kg) + 25% = 781 lb (3541a) z 450 lb (204 kg) 25% — 50 lb (255 kg)EI Ib ( kg) + 25%— lb ( kg) ffn 1011, Deftectiow Pin WFlul INSTALLED BY: FACILITY WITNESS: (Wc+gm lest only) ANGEL ACCESSIBILI' i SOLUTIONS: (Wci&ftsfioW WeiGN Teat Rapwt—Blank —1 .27.07—.dm w t AN C3E L ACCESSIBILITY SOLUTIONS o a w DATE RJ 00N On FACYLTX'Y ROOM # wu�G NEW INSTALLATION EXISTING NO. QF BEDS SYSTEM TYPE: (chwk ap bu=6 a ims u) GANTRY T nU14TABLB # MONORAIL Y L EVT MODEL # SERL4L # LEFT MANUF DAM— HANDCONTROL# MCK MODMING FA): WOOD CONCRM STEM FIDOR MOUNT a ri�eAr �t SY M C' ST: VIAL CEILING BRACKI Tr AND GAk} MY CAP SCREWS SECURE WSTALLED AND SECURES* AND SECURE** D S A S" ,I') AND TIGHTMaD _ CHARGER INSTALLED AND 1ESTED HAND OONTROL HOI DER/CLIP INSTALLED GANTRY WRUNG SE( URED —GANTRY BOOM RUM UNG TRUE LEFT HEAD 1RAVERS:NG TESTED UNDER NO L )AD CARRY BAR ER; .Y SECURED 3�GHT TESTED 7 D ALL POINTS ON TRACK TO SPECIIUD Ll[► ITS - SYSTEM WEIGHT LftffM 400 lb (181 W 1-25% - 500 lb (227 kO 625 lb (295 kg) + 25% - 791 Tb (354 kg) 450 lb (204 kg) 1- 25%= 563 lb (255 k) lb ( kg) + 25% = lb ( kg) r5" Da P =ss Fail Comments: T,AL BY: FACELXrY : (weer) ANGEL ACCES'SEBELi"J'Y SOMMONS: C wdbw Welgm Tat Rgxxt—abak —i .27.07 .doe /'� '_�3— a f Deoe IN14'N ACCESSIBILITY DATE 1 7— D 0) REGION �+ , '�a �' FACXLTTY ROOM # WING attil NEW IN T T10N Le:�_ E7Qs wG No. OF BEDS ^ I SYSTEM TYPE: (cheer ap Aia*k ids) 4ANTRY TURNTABI E # MONORAIL LIFT MODEL # SERIAL # LIFT' MANW. DATE: �' (I cx HANDCONTROL4 TRACK MOUNTING T(): WOOD CONCRETE STEEL lz'—_ FLOOR MOUNT SYSTEM , ' K W.— cEn xrra eRAc�cr rT AND GAMMY " SCREWS SECURE ffk B49VALLM AND SECURE" �* jX INSWALLED AND SECURE** END STOPS ADMSM 1) AND T[GNIENED CHARGER INSTALLED AND TESM _ HAND CONTROL H01 DS[tKLE? INSTALL® GANTRY VARING SE( URED GANTRY BOOM RUM HNG TRUE LIFT HEAD TRAVERS NO AZIJPPMWWER L UT CHECK ,,,,�UNDEIk NO L :SAD ,�ZtARRY BAR PROPER) .'off SECURED - WEMGiTT TESTED T D ALL POIIM ON TRACK TO SPBCHgED LMTS - SYSTEM WEIGHT LMTS 400 lb (191. kg) +- 25% SW lb (227 kg) 625 lb (295 kg) + 25% ='181 lb (354 kg) 450 lb (204 kg) +- 25% = 50 lb (255 kg) M Ib ( kg) + 25%= lb ( kph DeBedion: Piss EzIpall Comments: INSTALLED BY: FACILITY WITNESS: (Wright test only) ANGEL ACCESSIBILI'!'Y SOLUTIONS: (wcw Will0, T:: l2"- W ak& Teat RcpWt- Hants -t .27.o7—.dw t-7-o9 soma /-7-0 Date e§31u Vo 811 First Avenue, Suite 620 • Seattle, WA 96104 • tel: 206.292.5076 aroroza D 950 Pacific Avenue, Suite 1100 • Tacoma, WA 98402 • tel: 253.383.2797 sA, . STRUCTURAL CALCULATIONS FOR JEFFERSON GENERAL HOSPITAL CEILING PATIENT LIFT OT SCAN ROOM AND ROOMS 501 TO 331 PORT TOYNN5END, YVA5H INOTON PREPARED 5Y PC5 STRUCTURAL SOLUTIONS OCTOBER 15, 2005 OS-464 SCU PRIVATE ROOM PLAN Scale and/or dimensions are approximate and are to be used as a guide only. Optimum track and bracket placement lobe determined at Ume of InslallaUon. Brackets not shown on drawing. This drawing and the Information contained herein is the property of Angel Accessibility Solutions Ltd, and Is not to be copied or re -Issued. / .AN LL ACCESSIBILITY SOLUTIONS 2508 Bddga Street, Victoria, Bdlish CDlumbla CANADA VBT 51-13 T (250) 303-0405 F (250) 383.7099 Toll Free 1-B00-977-0721 E info®angeisolugons.com www.angelsolu(ions.com JEFFERSON HEALTH CENTER Port Townsend, Washington Ile Rev. Drawn By StWo 14/10/08 - VHM 3/8" =1'-0" Al m I CT SCAN ROOM PLAN Scale and/or dimensions ore approximate and are to be used as a guide only. Optimum track and bracket placementlo be determined at time of Installation. Brackets net shown on drawing. This drawing and the Information contained herein Is the properly of Angel Accesslblllty Solutions Ltd. and Is not to be copled or re-lesuod. FA II ACCESSNLIG IL 2508 Bridge Street, Victoria. British Columbia CANAOA V8T 51-13 T 950) 383A405 F (260) 3834009 Toll Free 1-SM977-0721 E Infoa@angelsolugons.com www.a ngel solud o ne.com JEFFERSON HEALTH CENTER Port Townsend, Washington 14/10/08 I - I VHM 1 3/8" = 1--0" SCAN Z O W Z Z O LL J Z J_ W U T- U) w LU F- Z LU U q LU 4 C � LJ,J t r = ro Z � O .o W LL LL r I z N ti rrl2_ m4 LUO J Q O� 0� g m N ul LU �L) �o N mh 20 w Z z 0 L- 0 i Cn .3 m o � L N O C YUf U m O LL W a - � Q o Z E E R w t0 0 v a dM E J m a > w U � a .a Z i c 0 U y U) m Ire vvnn E w .E Z � o co O o O LL W 04 O 04 pfw O 1p z 2 N N � � s Q O ~ ' Q O LU c U w m U) E E,i E 0 E o ow wm �- ' �- o c m J Uo S. Om w 0 N N O N- N m 0 C N m �'C O O O 10 o / 1 U \`'l` > IL W 57{ c 5, Q d o o v m m N ,o Rey No 0 Z 0 U w Z Z 0 J Z J_ W U V Z 0 IL 0 In ,f U) s" s g z s s W H W a U o w � u a U cv) � 2 L c 30 LwL LL ~ s W o '" N M ¢d uj� O �$ 0 F �a y m z mm arm . 5� �U ' m z o mm N Et 11 Z O U W z z O H LL (D z J_ W 0 J_ O z O 2 W H Z W U � W II m CO � Q c = Z cc O COLL- m N LL LL Q r- W2. "7 a O a r. Z O m� J O W ° ! E E 0 .2 T 'gg@a88 zm=�� U) zo � QU fs U rn Z U CO U I,. - CO w W F-- Z W U o W � n U 2 J � Q W c N 2 w Z v ' O � L W o 0 LL o LL W o a.P- Project: . . .. ...... , Job No: �Zpcs subject: SheetLL-- of — -------- Name: Structural Solutions Originating Office: ❑ Seattle ni-C'onia Date: ...... . . .... . I -x, 'J . ..... . ... X IIJ fN C tip" A y % 14, Scattlo 811 VirstAvctme, Suit,e 510 - SeatGOMA 9M04 . trot; 2062,RSU76 www.pug-structural.coryt z t7,-) 1; 1 StvolghTra.,,ck - Alu"num)"White edwdef Coal uk'b, c"mr, no im W%W'IXW MtAM) wm4 b TIC I VM)k I y OV WAVETUY , LIEN MICUS LtO N't; m Not To ix �.0 fc-mwb, sl 7: NIAUTM kx OMWI wuuf C', OLnUk f"XIMIC FUM wirpo" W $44"W" x rxitoak W w us; Nrr,. o iiwsw, y `4 lot cm, I-,GIKX4 (!wm) PAOTC41 CW SMV Y 6063-16 M"1104 0:F7 %W, sol . Lva 10) 14 $0 11444 tit t1,T117 070 03) OXXVIO 7wi 24 Mco) 01A) 104) AK) W3 2464) 4.37J 11 T� UAAWWA;,� A V,"A P,%-' C-t4 Y nf) LS PA)j Y(i IX COWX ,I) AS A'tbiisli�ki)64 Lvisam -N Roy 03/99 Wpit % .2ev— ;102 LM $ tip �........: G f Y r r' ,.N.w1� by e^f Ir�, IEFFERSON GENERAL 110$FITAL � � R%GG� �, a.n y v ✓ P J9, tl. q n .�., WsM ?�d d )KS Architects Pc MYY P !PM1'.%Rti:YM XM1tlll OMIMd xWPw*MvA V""M 0*91 A%% 04% SPOINNY SXf VV Ull ho ww#ooft *xh"A t*w 'IVIIdSO14 WHINIO NOSMAU 4T- ( t PT gig o 4 Project, . ......... lob �Zpcs Subject: Meet Structural Solutions Originating Office: 1' �NIC(alm Date: 0 C) 5Y� k1`2 I'J '47 Z41 It G! I First Avenue, StIfte 510 • Seattle, WA '�3f}joj 950 Pacific AvemAe., Suite 1100 VTacoma, WA 98402 - tes. 25, c' WWW. r)CS-SMOC t U r9d COM � Ill Admill pxoject� r- 'd I nsllptvc%� — "I'll Subject: Sheet Bo- of Structural Solutions originating office: [71 Seattle IL; coma -qm) 4"A (7l- C:> , , " -,� w s'? Cryaij, „gyp I�J n Job No:._ =, 461 Name: Date: J )-41)? 1,51 seefflo WWWPC8-SI:FLIcturaI.")m T9WIlla 1 950 PaCHIC Amme, Sll.dte 1100 Tamxna, WA 99402 - tel: 253,383.2797 Unistrut Component Detail Page 1 of 1 11 hUN I S ■ ,R. '! �Ttde Original Metal framing Part No. ,. Advnnred ha Pa@I 121111ac& (Downioa4 POEM ' ( Add To Cart ( Mew Cart (Oowaload CAD Bata P5501 • 1--615" x 4 7/8", 12 Gorao, Back -to -Back, Solid 4'" � nw qttrrtn q 4ttld111 p S S Gtq At1ua.valalut � --- Msrx Cotumin &oed U� c�tl�d,,�tt enra�o,NuM1k Finishes: M [_G KG, 2® PL weight. 494 Lbs1100 Ft (735 K91100 m) Cn40kAb!1.92n.0.1.:8A11k.dIGN.eaRls 16lomenta of Sactlen Area of Section -1.462 inz (9,4 cm2) Ands 1-1 o Moment of Inertia (1)-2,6051n4 (116.6 cm4) o Section Modulus (8) - 1,151 Ins (98,9 cm) o Radius of Gyration (r) - 1,390 in (3,6 cm) Axis 2-2 o Moment of Inertia (1) - 0.869 ina (27,8 m4) o SBctiot Modulus (5) - 0,023ln3 (13,5 cm) o RadtusofGyrabon(n)-0.679In(1.7cm) h'8ktth' Layo-pr)plt P5501 kAmnt h nYoor L1n i Atlasvrotspa tNSM ati at CV,aCts'cltre Urndoan tttatan�l part _ � B Load bead a18t fz44 Lateral 1, Above loads include the weight of the member, Thiswelght must be deducted to arrive at the net allowable load She beam will support, 2, Long span beams should be supported so as to prevent rotation and twlsi, 3, Allowable uniformly distributed loads are listed for various simple spans, that Is, a beam on two supports, If load Is concentrated at the center of the span, mullip(y load from the table 0.5 mxl eorrasponding deflection by 0,.8' 4, The lateral bracing factors Mo d be mulliplied by the load to date""roo the paad rwatw ri based on the,dWaneo betworm taltardt braces; Load on Channel: WOO 10AU r P U Mox Load Max Load fq„1K�Y' I 8,00D Lbs 2,200 K9 3A29 K9 9. 7otCY l� usuymt. 14101N sV I. Pk � ��Y n7n snarot��x �eP„61N.rcaU unwYrwnnr'x o�oo Brva, m,u.,,, aY,'nAno inmana.,r xrlll-1,el5H."nVu,lY,r.Mika SW. d"" 0,onx�iazotr6es try Max Low 31W Liss 1,4M K9 tycvlve r ice��AA�� Ale6ope" ;'.tN http://www.unistrut.com/Browse/cat—detail.php?S=S02&P=P5501 10/16/2008 Unistrut Component Detail Page 1 of 1 ji w UNST RU ■ The Original Metal Framing Part No. LrU Advnnccd parch .�rl„';»,!.. Q gad 1 Download P#F"( Add To Cxal ( View Carl ( Downtood CAD Data P5001 - 1-510" x 6 V2", 12. Gnoo, E auk-to-Ba€;k, Solid 41. ( � �. e 1' MONONAptu t If' r p w Colt �..�w. Atreowabtn UnItuacod Load art ttokol SW Pao C.hanpel $,gleclion,Chart, RwtAv9fl.(W.h,.®nnel, Nuls Finishes: GR PG HG PL Weight: 610 Lbs1100 Ft (900 Kgl100 m) Vv i4 r„a9,,.fifwgwkpr"njl�w.bI Elements of Section Area of Becton - 1,,7931n2 (11,0 Gm2) Axis 1.1 11 136'0d1:1 Beam Lo sprat • P5001 Mdx tiarw4 4sttidrtup Lateral MlloxCotwttn lord mowtiasio dg at ar[ tTagos+lo „p vd�upR�Ct2.,, .. uniform NJr4/eym 6pan owru SNy , Llrsc.9rag K 0itlw F111tr5 t4n00 5apr Load load 11 $0 4740 r390 Radur:"o o Moment of Inertia (1) - 6.2271n4 (259,2 M4) e Section Modulus (8) - 1,918 Ina (31,4 cm3) a Radius of Gyration (r) - 1,684 in (43 cm ) Axis 2-2 o Moment of Inertia (1) - 0,868 In" (36,0 cm4) a Section Modulus (S) - 1,066 Ina (17,5 cm) o Radius of Gyration (r) - 0,605 In (18 cm) 1. Above loads Include the weight of the member, This weight must be deducted to arrive at the net allowable load the beam will support. 2, Long span beams should be supported so as to prevent rotation and twist. 3, Allowable uniformly distributed loads are listed for vadous simple spans, that Is, a boom on two supports. If load Is concentrated at the Center of the span, multiply load from the table by 0.5 and corresponding deflection by 0,8, 4, The lateral bracing factor should be multiplied by the load to dat"Wroino the load lotalmmd b000i on Ow dWano% hotwoon lo'lroral braces. nrtng Lead 9" Channel: Vk%', 1ttAo. �trttita r jj6r u err; 5 Max Load Ma LOW Max Load 4;t100 Lb% 6,500 Lbe 2,000 q bs 1,814 Xg Z495 Ka 110'7 k1'v u'52vWMS l" .Vw Multi IAIIVI 'F -,m u—J el"N'1m e'q"a,. rV 6uY,r...v uQ trlu-rran noLL u4n'Ur,.l.�ul,tt u.�i.i �. al m'utR�u summtrcv tqca1'q,K,i,,rw& http://www.unistrut.com/Browse/cat—detail.php?S=S02&P=P5001 10/16/2008 Unistrut Component Detail UNISTRUT"",rh. oiglnal MOW Framrisg vllfiia� MEM 0 Back ( Download FDF", ( Alld-toCaTt ( View Cart (" Dowilood CAD Data Now a Wien used for modinnicat supports, load capacities of brackets and fifflngs should be In compliance with the Amadcan Standard Code for Pressure Piping, Finishes; gR EQ JM Weight: 72 Lbi/100 Poe (323 Kg11 00 Pea) Additional S�sGlf.4dail. 29z� I IV VA I wip �t�'x P" &A ftnOW and Nut h lwo'lowr* P,ry I �A% JUM Nut 601 2 HOU4 %a" e 14r)tk 66?* w qO %1V Rod NIMVM is, NORP An? WoZoro P. Hdn.ti Ae, III II. Die, Glwnp MaW6,148; W (U) MO lmot% X" find Sao up to W, CIAMP PR670 provikJo6 a means of rod tuiisongioji where, a free swing of OederswIyeInMP26"4,-G.or.Uns ratpon,W, Clarnp, onny also be used w4h P2677 in Rhishalstl In appl"llon dramn4i q541 PAR& Ile, In MU U,,N!,0 All R6rft9'R—"' I ','JA"*. i, mU.dui.4-Ir U,16UW ONW. h, U. 10. Oh" "'h—wwk, Page I of 1 11 Tyco/sy'wowd MonarPro0avis http://viww.unistrut.com/Browse/cat—detail.php?S=SO5&P=P2676 10/16/2008 Unistrut Component Detail Page I of I UN,ISTRUT The Original Metal Framing PArt No. . . . . . . . . . . . . . 13 Bull (. Download PDF Add T. Carl ( View Corl i Do*flfD44 ICAO Data P2398S, Finis h":Gil W., Jilt Weight: iW L1311100 PCs VOOKWiticipc4) A0401,191 9.001cifloftlo. . IMS VI-W A Q k4W rm.m * ". ,qA_$ V.N-A u UW6,.'A Q1 UI.WW P24015, P2403S -Beam Clamp (1.518" Seriet) ronNum'n ii Sol ucoft WOW , — swa c "Kh"W4 iT rat lM�d $inx. A V V, Des P "I pan lr .9. "c_ '0' WknWpn Low WOW 10 tft (040 Ile Na No) LU fad Lbs 010 For beams botwoon �.' (190) to If/V (41,3) thick flanjet Ptawarr;ate km?"P 0A."xg http://www.unistruLcom/Browse/cat—detail.php?S=SO5&P=P2398S 10/16/2008 Unistrut Component Detail Page I of I JA UNISTRUTT/se Original Metal Framiri%y Part No, Adwlxd J3 Back ( Dawnlead 0,DF*" ( A4d To Cart ( Vqow Gal C OperIl GAO Data U6110; mi When used for mechanical supports, load capacities of brackets and fittings should be In caml with One American Standard Gods for Pressure Piping, Finishes: FQ ,, HIP ZP Weight: 53 Lbs/1100 Pas (37 9 Kg/100 Pcu) azmj�� 1W Hex No W 'U' Bob =L:z J, - For ow with Beams up W 'A (19,1) Flanges and with Channels PlaW, PI IUD, PZWx Pal P3300. P3301, P4000, P40011, P4100, and P41101. 0 2161 AU YU 4b�, 111—,d Uj ."1140 i" U,d—�Wv,u Wdan,,* ed 0'44'a ("'qroum!." to u4A o Viv'offiW0o.' " 0", Th'N,M'RW', MhLm —'Inlfl" Vqcla/=111111111�11!11. http://www.unistrut.com/Browse/cat—detail.php?S=S05&P=P278S 10/16/2008 Installation SpecificationS ecii a `' Straight Track - Aluminum/White Powder Coat NOTE: THIS DRAWING AND THE INFORMATION CONTAINED HEREIN IS THE PROPERTY OF WAVERLEY GLEN SYSTEMS LTD. AND IS NOT TO BE COPIED OR REISSUED. 3 �- t✓s� 1 MATERIAL 6005A—T6 ALUMINUM ALLOWABLE DEFLECTION DESIGN FACTOR OF SAFETY (10' PIECE, 60OLB LOAD) 1 /200 a MATERIAL YIELD STRENGTH 37 KSI 42 KSI MATERIAL ULTIMATE STRENGTH 3.1559 SOUARE INCHES AREA DEFLECTION (10' PIECE, 600LB LOAD, SIMPLE SUPPORTS) .508° THIS DRAWING IS A GUID%WE ONLY, AND IS NOT TO BE CONSIDERED AS A CONSTRUCTION DRAWING. Waverley Glen Systems Ltd. 1275-3.spec.specification E. & O.E. EE 9ORT CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT INSPECTION REPORT CALL THE INSPECTION LINE AT 360-385-2294 BY 3:00pm THE DAY BEFORE YOU WANT THE INSPECTION. FOR MONDAY INSPECTION, CALL BY 3:OOPM FRIDAY. I PERMIT NUMBER: -2 DATE OF INSPECTION: SITE ADDRESS: CONTACT PERSON: PHONE: TYPE OF INSPECTION: ❑ APPROVED 0 APPROVED WITH 0 NOT APPROVED CORRECTIONS Ok to proceed. Corrections will be Call for re -inspection before checked at next inspection proceeding. T11- Inspector Date.,_ Acknowledgement Date Approved plans and permit card must be on -site and available at time of inspection. A re- inspection fee may be assessed if work is not ready for inspection. Dana, In the future when you have a building permit you will need to follow the building permit inspection card and call for the required inspection at the point of construction before cover. The International Building Code 2006 Section 109.5 Inspection Requests states: It shall be the duty of the holder of the building permit or their duly authorized agent to notify the building official when work is ready for inspection. It shall be the duty of the permit holder to provide access to and means for inspections of such work that are required by this code. Regards, Rick Taylor 2/12/2009 LL LL O ❑ W w t co ❑ W Z x r W z ❑ O Q w Ix Q J N Q Z > O a UW Co W r IL v7 W � W Z J C a W ❑ w W > Q a J z Q � ❑ L) a z y v7 } 2 Z r Q W a o D � U W U � O r � O o Z LL 0 W Q IL uJ a J Q IL N z O O r Z Q O J O7 J m :3 x O r U Z a Q z H O Fx O LL x LL r Q Q Q w z¢_ ❑ Ir LL Q CC U a ti a x a r w x vri r a CO a E u� c 00 C. 0 N a: 00 0 0 J m O Z r W a N Cl) OD v rn O Z J W U Q IL aW r _ Z c OOL r rL co U Z O W U Z ❑ O J r a U w r U a H LL1 w Of r ZCl) Q w U) V Cl) 00 U w ❑ ❑ Q N H 0 U) O S J m D 0- 0 U z O U) w LL LL w W z O w a IL U) Z z O F U W a Z N r z w O U z O f- U W a z J C7M Z LL W r cn J H U) z p J =3Q m Q z LL O W Z J U)[L Z O H U w a U) Z 0 F rn Z N O 000 LL r2 o a M C J M QO U z 52 P:W- U a W IL w u> > zW Zw Q � F W Nui m 7 F- wD It � 0 H w D W W. Z O U w a N Z