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HomeMy WebLinkAboutBLD07-170City of Port Townsend Development Services Department 250 Madison Street, Suite 3, Port Townsend, WA 98368 (360)379-s095 BIJILDING PtrRMIT Project Information Permit'fype CommercialMiscellaneous Site Address 834 SHERIDAN Project Description Converting office spaces into Urgent Care clinic space Permit # Project Name Parcel # BLD07-r70 9483t9202 Names Associated with this Project Typ" Name Applicant Jefferson Co publ Hosp Disr #2 Owner Jefferson Co Publ Hosp Dist #2 Fee Information Project Valuation Building Permit Fee Plan Review Fee State Building Code CouncilFee Technology Fee for Building Permit Record Retention Fee for Building Permit Phone # Project Details Entered Bid Valuation License # Exp Date License TypeContact $220.000.00 r,665.7 5 t,082.74 4.s0 33.32 10.00 220,400 DOLI Total Fees $2,796.31 X** SEE ATTACHED CONDITIONS *** Call 385-2294 by 3:00pm for next day inspection. Permits expire 180 days from issuance if work is not commenced, or if rvork is suspended for a period of 180 days. Work is verified by obtaining a valid inspecfion. The granting of this pennit shall not be construed as approval to violate any provisions of the PTMC or other laws or regulations. I certify that the infonnation provided as a part of the application for this pennit is true and accurate to the best of my knowledge. I further certify that I am the orvner olthe properfy or authorized agent ofthe owner. -?Ja Print Name Date lssued: lssued B1,: t0/08/2007 PWESTEMIELD futro/u F;"*(yt-"LeW t/,/"e ) BIJILDING PtrRMIT City of Port Townsend Development Services Department 250 Madison Street, Suite 3, Port Torvnsend, WA 98368 (360)379-so9s Project Information PermitType Commercial Miscellaneous Site Address 834 SHERIDAN Project Description Converting office spaces into Urgent Care clinic space Permit # Project Name Parcel # BLD07-170 948319202 Canditions 10. Alterations or extensions of the fire alarm and/or fire sprinkler systems require separate permits 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 construed as approval to violate any provisions of the PTMC or other laws or regulations. I certily that the infonnation provided as a part of the application for this pennit is true and accurate to the best of my knowledge- I further certify that I arn the owner of the property or authorized agent of the owner. Date Issued: lssued By: t0t08t2001 PWESTERFIELD Print Name ) City of Port Townsend Development Services Department 250 Madison Street, Suite 3, Port Torvnsend, WA 98368 (360)379_s09s BIJILDING PERMIT Project Information Permit Type Commercial Miscellaneous Site Address 834 SHERIDAN Project Description Converting office spaces into Urgent Care clinic space Permit # Proiect Name Parcel # BLD07-170 948319202 Numes Associated with this Project Type Name Applicant Jefferson Co Publ Hosp Dist #2 Owner Jefferson Co Publ Hosp Dist +]) Contact Phone # License Type License # Exp Date Fee Informotion Project Valuation Building Permit Fee Plan Review Fee State Building Code Council Fee Technology Fee for Building Pemit Record Retention Fee for Building Permit Project Detuils Entered Bid Valuation 220,000 DOLL $220,000.00 1,665.75 1,082.74 4.s0 33.32 10.00 Total Fees $2,796.31 *** SEE ATTACHED CONDITIONS *J<* 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. Thegrantingofthispermitshall notbeconstruedasapprovaltoviolateanyprovisionsofthePTMCorother-lawsorregulations. Icertify that the infonrration provided as a part of the application for this perrnit is true and accurate to the best of my knowledge. I further certify that I arn the orvner ofthe ploperty or authorized agent ofthe owner. .J,Ja Print Name Date lssued lssued By: 10/0812007 PWESTERfIELD ') BIJILDING PERMIT City of Port Townsend Development Services Department 250 Madison Street, Suite 3, Port Townsend, WA 98368 (360)379-s09s Project Information PermitType CommercialMiscellaneous Site Address 834 SHERIDAN Project Description Converting office spaces into Urgent Care clinic space Permit # Project Name Parcel # BLD07-170 948319202 Conditions 10. Alterations or extensions of the fire alarm and/or fire sprinkler systems require separate permits 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 construed as approval to violate any provisions of the PTMC or other laws or regulations. I certify that the inforr.nation provided as a part of the application for this permit is true and accurate to the best of my knowledge. I furlher certify that I anr the owner ofthe property or authorized agent ofthe owner. Date lssued lssued 81,: t0t08t2007 PWESTERFIF-I ,I) Print Name CO N S T R U C T I O N PR O G R E S S RE C O R I ) CI T Y OF PO R T TO W N S E N D De v e l o p m e n t Se r v i c e s De p a r t m e n t 25 0 Ma d i s o n St r e e t . Su i t e 3. Po r t To w n s e n d . WA 98 3 6 8 PO S T TH I S CA R D II \ A SA F E , CO N S P I C U O U S LO C A T I O N . PL E A S E DO NO T RE M O V E TH I S NO T I C E UN T I L AL L RE Q U I R E D IN S P E C T I O N S AR E MA D E AN D SI G N E D OFF BY TH E AP P R O P R I A T E AU T H O R I T Y AN O TH E BU I L D I N G IS AP P R O V E D FO R OC C U P A N C Y , ST A M P E D AP P R O V E D PL , A , N S MU S T BE AV A I L A B L E ON TH E JO B S I T E . PA R C E L NO , 94 8 3 1 9 2 0 2 PE R M I T NO . BL D 0 7 - l 70 IS S U E D DA T E 10 t 0 8 t 2 0 0 7 EX P I R A T I O N DATE o4105t2008 AD D R E S S 83 4 SH E R I D A N CO N S T R U C T I O N TY P E oc c u P A N T LOAD _ OW N E R JE F F E R S O N CO PU B L HO S P DI S T # 2 PR O J E C T DE S C R I P T I O N Co n v e r t i n o of f i c e sp a c e s in t o Ur q e n t Care clinic space CO N T R A C T O R LE N D E R IN S P E C T I O N IN S P DA T E CO M M E N T S IN S P E C T I O N IN S P OA T E COMMENTS FI N A L BU I L D I N G CO N C R E T E FR M . P L M - M E C H [s L O C K I N G FI R E S T O P P I N G SH E A R WA L L IN S U L A T I O N GW B ME C H A N I C A L BA L A N C I N G CE I L I N G GR I D LI G H T I N G AC C E S S I B L I T Y FI N A L . E L E C - I N S P FI N A L . D O H . C S FI R E AL A R M FI R E . F I N A L TO RE Q U E S T AN IN S P E C T I O N CA L L (3 6 0 ) 38 s - 2 2 9 4 . IN S P E C T I O N RE Q U E S T S MU S T BE RE C E I V E D PR I O R TO 3: 0 0 PM FO R NE X T DA Y IN S P E G T I O N . )CITY OF PORT TOWNSEND PERMIT ACTIVITY LOG PERMIT # R LD 01 - t-70 SCOPE OF WORK: DATE RECETVED B-t4 -OV DATE ACTION INITIALSR- 14- b7 ENTERED INTO CHET CA - to Plannine - No evidence CHECKED FOR COMPLETENESS h -14- O7 ,A Ot tTdI 9 nla &r i nl+-tar {ur,rL -h 'ro'no|<Js €X i sli rY tr.x<- 6k-J Qal La q r.i-o lr r/>- R - o-7 AQttY t ( alt?l n*I SL- t 4 -/+F J f 9 -70- 0K 4ot z-L 6F O I .4/(" - / 7-0%/1C I v a CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT INSPECTION REPORT For inspections, call the Inspection Line at 360-385-2294 by 3:00 PM the day trefore you want the inspection. tr'or Monday inspections, call by 3:00 PM Friday. DATE OF'INSPECTION: 8_8^OE PERMIT NUMBER: SITE ADDRESS: PROJECT NAME: CONTACT PERSON: CONTRACTOR: PHONE: TYPE OF'INSPECTION: \ae{ ! APPROVED V^.rt APPRovEt)/\ Cali\r re-inspection before proceeding. ! APPROVED WITH CORRECTIONS Ok to proceed. Corrections will be checked at next inspection Inspector Date Approved plans and permit card must be on-site and qvqilable at time of inspection. A re-inspection fee may be assessed if work is not readyfor inspection. a .i CITY OF PORT,TOWNSEND DEVELOPMEIVI SERVICTS DEPARTMENT INS?ECTION REPORT For inspections, call the Inspection Line at 360-385-2294 by 3:00 PM th'e day before you want the inspection. For Monday inspections, calt by 3:00 pM Friday. DATE OF INSPECTION: S - q PERMIT J':, r' I SITE ADDRESS: PROJECT NAME: CONTRACTOR: CONTACT PERSON:PHONE: TYPE OF INSPECTION:tj ("'' lrl ll IL- nL ! APPROVED (r F NOTAPPROVED Cal'i for re-inspection before proceeding. WITH- ONS Ok to proceed. Corrections will be checked at next inspection Inspector Ll lngF Date "t t) Approved plans and permit card must be on-site and ovailable ot time of inspection. A re-inspectionfee may be ctssessed if work is nol ready for inspection. For inspections'call the InsPection the CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT INSPECTION REPORT Line at 360-385-2294 by 3:00 PM the day before you want For MondaY inspections, call tly 3:00 PM Friday' PERMIT NUMBER:B da+- l ?0 TOR: PH fz r\oi kb,n 4-"& qs'f DATE OF INSPECTION: SITE ADDRESS: PROJECT NAME: CONTACT PERSON: TYPE OF INSPECTION: OA 6v< /We"l'was OL ( J-r\e DO tr APPROVED tr APPROVED WITH CORRECTIONS Ok to proceed. Corrections will be checked at next insPection Date Approved plans and permit card must be on-site and available at time of inspection be- assessed if work is not ready for inspection' )( Nor APPRovED Call for re-insPection before proceeding. A re-insPectionfee maY Inspection Report Project -) it t',e permit n 6D/f-/ 7d I Date lnspector lnspection & Notes V,,K \{NA t*, RA, P.r-,-ae- t{-+ /o \l F<. 1,t<De,, ) ceJ\uc-, ""A-m /tu,[-o,.u > fi"*t.J 2 Construction Review Services Ftme Page Page 1 of2 / fqni[i*r nnd Ssrs*nn$ tringnsiw ^ & j #t;;?rd ffiXffik*ffiffi sf*rfitEs You are here: DOH Home >> HSQA >> FSL >> CRS S$te ffi$rmct*ryr fiffi.S: trrm$mct Stmtss nstruction Review Services (CRS) o CRS Home Facility Name Facility City Project Type Project Title Status Date o s/t7/2008 sl17/2oog slL7/2OOB : JEFFERSON HEALTHCARE HOSPITAL : PORT TOWNSEND : Hospital Project : FAST TRACK URGENT CARE PROJECT Project Number Project Start Date Project StatusS Project Status Reason 0 Project Close Date Search I Emplovees :6OO75573 : o4/72/2oo6 : PENDING : AUTHORIZEI TO BEGIN CONSTRUCT, Note: For sortin click the column headers below. Froj*ct ffi*tafiflm Item Status s WorkFlow Descrip_tiOl s 2. Approved Small Projects Plan Rr 2, Approved Small Projects Plan Rr 2. Approved Small Projects Plan Rr Tarqet ltems Date Received 00 Fee Paid Finishes Ceiling Tile Sample Letter 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@do h. wa. gov. DOH Home I HSQA Online Search I Access Washington I Privacy Notice I Disclaimer/Copyright 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 https://fortress.wa.gov/doh/constructionreviewlookup/step4-project-profile.asp?pid:60015... 712512008 CITY OF PORT TOWNSEND DEVELOPMENT SERVICES DEPARTMENT INSPECTION REPORT For inspections, call the Inspection Line at 360-385-2294 by 3:00 PM the day before you want the inspection. For Monday inspections, call by 3:00 PM Friday. DATE oF INSPECTIoN: E ^q PERMIT NUMBER: 1 - 11 0 SITE ADDRESS: PROJECT NAME:CONTRACTOR: CONTACT PERSON:PHONE: TYPE OF'INSPBCTION: N L ! APPROVED WITH Ok to proceed. Corrections will be checked at next inspection ! NOTAPPROVED Call for re-inspection before proceeding. Inspector Date Approved plans and permit card must be on-site and ovailable at time of inspection. A re-inspectionfee may be assessed if work is not ready for inspection. Development Services 250 Madison Streef, Suite 3 Port Townsend WA 98368 Phone: 360-379-5095 Fax: 360-344-4619 unmv.cityofpt.us Commercial Building Permit Application F Applications accepted by mail must include a check for initial plan review fee of $150F See the "Commercial Building Permit Application Requirements" for details on plan submittal requirements. Gontractor: Name: Address City/SVZip:_ Phone: Email State License #:_Exp City Business License #: I hereby certify that the information provided is correct, that I am either the owner or act on behalf of and that all activities associated with this permit will be in accordance with State Laws the il?,wn',.",i9 f{,Y,i i J I u irPrint Name Project Address & Zoning District:Legal n (or Tax #): s/,Addition Block tqL Parcer# q48 3lq 2Dz Lot(s 3 slest Project Descri ption:(Ta.rn S{on? - 4. Office Use Onlv Permit # )Associated Permits: al k lr o- Name Phone Email City/StlZip Address: Lender lnformation: Lender information must be provided for projects over $5,000 in valuation per RCW 19.27.095. Name Project Valuation: $o a4 Address: .7? q 4Z n.,,c e ,/L .-'Jaaa >. Pho /t 'L -3?z z:/.?q I ./zt, -lqte A-rt t40 City/SVZip:ft Email Name Building lnformation (square feet): o4 l"tfloor 225f7 Redtrooms Basement:_ ls it finished? Yes No Other: New n Addition I Remodel/Repair ry Change of UseF Construction tl t(Occupancy Rating 2ndftoor6Zfla Deck(s 3'd ftoor 20 / t L .+ Total Lot Coverage (Building Footprint) Square teet:QL llQ-.- lmpervious Surfacel Square o//o Signature F*4 r.L< (j Date v- ,/q- o 7 the ownler icipalCbd e. COMMERCIAL BUILDING PERMIT APPLICATION CHECKLIST This checklisf is for new construction, additions, and remodels. The purpose is fo show what you intend to build, where it will be located on the lot, and how it will be constructed. * Commercial building permit application. I Non-Residential Energy Code forms: * Lighting * Mechanical * Envelope I Three (3) sets of plans with North arrow and scaled, no smaller than /o" = 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 numbers4. Name, address, and phone number of person responsible for project coordination5. 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 survey4. On-site parking and driveway.with dimensions5. Street names and any easements or vacations6. Location and diameter of existing trees7. Utility lines B. lf applicable, existing or proposed septic system location 9. Delineated critical areas boundaries and buffers I Foundation plan: 1. Footings and foundation walls2. Post and beam sizes and spans3. Floor joist size and layout4. Holdowns 5. Foundation venting I Floor plan: 1. Room use and dimensions 2. Braced wall panel locations 3. Smoke detector locations 4. Attic access 5. Plumbing and mechanical fixtures6. Occupancy separation between dwelling and garage (if applicable) 7. Window, skylight, and door locations, including escape windows and safety glazing I Wall section: 1. Footing size, reinforcement, depth below grade 2. Foundation wall, height, width, reinforcement, anchor bolts, and washers3. Floor joist size and spacing4. Wall stud size and spacing 5. Header size and spans6. Wallsheathing, weather resistant barrier, and siding material7. Sheet rock and insulation B. Rafters, ceiling joists, trusses, with blocking anb positive connections9. Ceiling height .\ -1 -) Receipt Nunber: BLD07-170 948319202 Plan Review Fee CHECK 60645 Total $1,082.74 Total $250.00 74$832. $250.00 $ 250.00 $250.00 genprntrreceipts Page 1 of 1 t Air Handling Unit Report PROJEGTI Fast Track Urgent Care Project Jefferson Healthcare LOCATION: Port Townsend, WA PROJECT #: 2008-438 DATE:812112008 CONTACT: Rory McCarthy ff lf"g"i|.$,?*qrH[p'H!-?**t*,,lJFf;'' Unit Data Unit Manufacturer Unit Model Number Unit Serial Number Unit Discharge Existinq AHU 2.1 / SF Filter Bank Filter Quantity - Size 1 Filter Dimensions - Size 1 McQuay OAHOlOGPAC F8OU50900805 Vertical 2 12x24x4 SYSTEM/UNIT: Existing AHU 2.1 AREA: Tested By: Lance Jonson Test Date: August 20, 2008 Test Pressures OA Damper Pos 100 o/o Motor Data Existinq AHU 2.1 / Supplv Fan Motor Manufacturer Motor Frame Motor HP Motor RPM Motor Rated Volts Motor Phase Motor Hertz Motor FL Amps Motor Service Factor Brake Horsepower Existinq AHU 2.1 / Exhaust Fan Motor Manufacturer Motor Frame Motor HP Motor RPM Motor Rated Volts Motor Phase Motor Hertz Motor FL Amps Motor Service Factor Baldor 2157 7 1t2 1750 200 3 60 23 1 .15 6.50 BHP Reliance Electric 182TC 3 1745 230 3 60 8.40 1.'t5 Test Data Total Design Flow Total Actual Flow EA Design Flow EA Actual Flow Existinq AHU 2.1 / Supplv Fan Fan RPM Actual VFD Setting Motor Amps Tl Motor Amps T2 Motor Amps T3 5710 CFM 5125 CFM 4270 CFM 3875 CFM 3OOO RPM 52.30 Hz 20.70 Amps 20.70 Amps 20.70 Amps Sheave Data Existinq AHU 2.1 / SupplV Fan Motor Sheave MFG Motor Sheave Model Motor Sheave Bore Fan Sheave MFG Fan Sheave Model Fan Sheave Bore Number of Belts Belt Size Sheave Center Line Motor to Extend Motor to Retract Existinq AHU 2.1 / Exhaust Fan Motor Sheave MFG Motor Sheave Model Motor Sheave Bore Fan Sheave MFG Fan Sheave Model Fan Sheave Bore Number of Belts Belt Size Sheave Center Line Motor to Extend Motor to Retract Browning 2AK6.1H H1 3/8 in. Browning 2AK3O H1 7l'16in. 2 AX37 12.50 in. 2 in. 2in. Browning 1VP5O 1 1/8 in. Browning AK56 H 1 114 in. 1 445 13.75 in. .75 in. 1 in. Neudorfer Engineers, lnc. i* f Neudorfer Enoineers. lnc. I d consulrinoEmlisars ssanld'Fbrllend olyinn;a Guam -i Air Handling Unit Report PROJECT: Fast Track Urgent Care Project Jefferson Healthcare LOCATION: Port Townsend, WA PROJECT #: 2008-438 DATE:812112008 CONTACT: Rory McCarthy SYSTEM/UNIT: Existing AHU 2.1 (Cont.) AREA: Existing AHU 2.1 Supply Outlet Summary Tested By: Lance Jonson Test Date: August 20, 2008 System., Unit Area Served Type of Reading Outlet Type Size LxW /D AK Design Velocity Design Reading Prellm Reading Final Reading Finalr o/o Remarks Outlet-Ol 112 Hood CD 8"1 250 185 225 90 Outlel02 113 Hood CD o 1 250 170 230 92 OutlelO3 114 Hood CD o 1 140 110 135 96 Outlet-04 116 Hood CD o 1 110 95 100 91 OutletO5 126 Hood CD 5"1 190 220 170 89 Outlet06 117 Hood CD o 1 190 185 175 92 Outlet-OT 128 Hood CD o 1 120 160 115 96 Outlet-08 '128 Hood CD 5"1 100 100 100 100 OutletO9 105A Hood CD o 1 70 25 70 100 Outletl0 105A Hood CD 5'1 115 45 105 91 Outlet-11 105A Hood CD 5'1 85 45 80 94 Outlet-12 105 Hood CD o 1 165 180 155 94 Outlet-13 109 Hood CD 12"'l 200 230 180 90 Outlet-14 110 Hood CD 12",|200 30 180 90 Outlet-15 111 Hood CD 12"1 125 180 125 100 Outlet-16 127 Hood CD 6"1 100 100 90 90 Outlet-17 127 Hood CD 6 1 75 135 75 100 Outlet-18 118 Hood CD o 1 150 120 145 97 Outlet-19 123 Hood CD o 1 75 55 75 100 Outlet-20 122 Hood CD 6"1 150 65 145 97 Outlet-21 106 Hood CD 8"1 150 65 150 100 Outlet-22 102 Hood CD B"1 200 300 200 100 Outlet-23 Exam 65-M288 Hood CD 6"1 550 290 450 82 Outlet-24 Wait 65-M28s Hood CD Bx8"1 520 300 415 80 Outlet-25 Wait 65-M285 Hood CD 8x8"1 560 45 455 81 Outlet-26 Exam 65-M289 Hood CD o 1 90 165 B5 94 Outlet-27 Hall Hood CD 6"1 240 130 210 88 Outlet-28 *Wait 65-M287 Hood CD o 1 75 125 65 87 Outlet-29 Chart Hood CD o 1 150 50 135 90 Outlet-30 Exam 65-M291 Hood CD 6"1 150 220 135 90 Outlet-31 165 320 150 91 Totals :5,710 4r445 5,125 90% Neudotfer Engineers, lnc. '"iN Neudorfer Enoineers. lnc. $aattlsv F,\ofltsnd Oly'mpiu GuamConr$ullins Eruln*!6rs Air Handling Unit Report PROJEGT: Fast Track Urgent Care Project Jefferson Healthcare LOGATION: Port Townsend, WA PROJECT #: 2008-438 DATE:812112008 GONTACT: Rory McCarthy SYSTEM/UNIT: Existing AHU 2.1 (Cont.) AREA: Existing AHU 2.1 Exhaust Inlet Summary * Notes Tested By: Lance Jonson Test Date: August 20, 2008 System / Unit Area,Served Type of Reading ,Outlet Type Size.LxW to AK Design Velocity Deilgn 'Reading Prelim Reading Final Reading Final % Remarks lnlet-Ol 112 Hood EG I 1 350 325 315 90 lnlet02 113 Hood EG 8.1 70 70 70 100 lnlet-03 114 Hood EG I 1 40 60 40 100 lnlet04 115 Hood EG 6"1 410 225 240 59 lnlet-O5 116 Hood EG 10"1 30 30 30 100 lnlet-06 117 Hood EG B"1 75 40 70 93 lnlet-07 120 Hood EG o 1 2SO 115 260 90 lnlet08 120 Hood EG o 1 50 40 50 100 lnlet-09 125 Hood EG o 1 200 100 195 98 lnlet-10 111 Hood EG 10"1 200 0 "t90 95 lnletl 1 110 Hood EG 10.1 215 90 195 91 lnlet-12 109 Hood EG '12"1 400 170 370 93 lnlet-13 124 Hood EG 8"1 370 210 360 97 lnlet-14 122 Hood EG 1 0x6"1 145 70 140 s7 lnlet-15 1 05A Hood EG 7"1 120 240 115 96 lnlet-16 105 Hood EG B 1 410 280 400 98 Inletl T 1 06?Hood EG 8"1 50 45 45 90 lnletl S 65-M288 Hood EG o 1 225 175 220 98 lnlet.l9 65-M289 Hood EG 6"1 50 35 50 100 lnlet20 Hall Hood EG 10"1 50 45 45 90 lnlet2l 65-M291 Hood EG 6"1 140 110 130 93 lnlel-22 380 230 345 9l Totals 4;270 2i7t5 3,875 91o/o Existing AHU 2.1 Existing AHU 2.1 Existing AHU 2.1 Existing AHU 2.1 i Outlet-28 Existing AHU 2.1 / Outlet-28 Existing AHU 2.1 i Outlet-28 Existing AHU 2.1 / Outlet2S Existing AHU 2.1 i Outlet-28 Existing AHU 2.1 / Outlet-28 Existing AHU 2.1 i Outlet28 Existing AHU 2.1 / Outlet-28 7-Aug-08 7-Aug-08 7-Aug-08 20-Aug-08 20-Aug-08 20-Aug-08 20-Aug-08 20-Aug-08 20-Aug-08 20-Aug-08 20-Aug-08 #28/29 NOT INSTALLED 90% DRIIVE SPEEDIIS MAX FAN RPM SUGGEST CHANGING SHEAVS FOR O ERATION AT 3000RPM @60H2 RESTZE BOTH SHEAVS FOR INCREASED BELT TRAVEL (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. Neudorfer Engineers, lnc. ]Y E U D O R F E R E ]Y G IIV E E R,S ITTC. TEST, ADJUST & BALANCE BALANCE REPORT Jefferson Healthcare Fast Track Urgent Care Port Townsend, Washington 2008-438 Project Completion Date: Revision Date:Revision Number: PO Box 24327 MPO Barrigada, Guam 96921 Phone (671) 637-7810 Fax (671) 637-7842 01t04t09 5s16 1d Ave S Seattle, WA 98108 Phone (206) 621-1 810 Fax (206) 343-9820 1 500 NE Sandy Boulevard, Suite #1 Portland, OR 97232 Phone (503) 235-8924 Fax (503) 235-8925 1 930 Carpenter Road SE Lacey, WA 98503-2915 Phone (360) 528-8694 Fax (360) 528-8695 WILLIAM C. NEUDORFSR CERTIF'CAT'ON 2465 Exp.1?31/08 En ro n\c F f Ncudorfer Enginecrs, lnc. $ 3 t:or[;rrll:rtrl l rrtrrrr:rrr i;r:irill1J J'{rrtliu:it OlVrilp;ir (irl,ili, ts*.l{{!{trilltrlr ilil Report Title CERTIFIED TEST: BALANCE REPORT Project: Jefferson Healthcare Fast Track Urgent Care Port Townsend, Washington NEI Job#: 2008-438 Engineer: Gontractor: Jefferson Heatthcare TAB Firm: Test Engineer: Neudorfer Engineers lnc Lance Jonson 55 16 1"tAve s Seattle, WA 98108 Phone (206) 621-1810 Fax (206) 343-9820 1 500 NE Sandy Boulevard, Suite #1 Portland, OR 97232 Phone (s03) 235-8924 Fax (503) 235-8925 PO Box 24327 MPO Barrigada, Guam 96921 Phone (671) 637-7810 Fax (671) 637-7842 614 4thAve. E. Olympia, WA 98501 Phone (360) 528-8694 Fax (360) 528-8695 WLL'AM C. NEUDOHFER CERTIFICATION 2465 Exp.lugl0g U"E nic F f Neudorfer Engineers, lnc. $ 3 (:(ilr'it,llingl.r.lirlr:ut$ :;r'rl!lL. lorllirrl Ulynrlr;a (irt;trrr CERTIFICATION Jefferson Healthcare The data presented in this report is a record of system measurements and final adjustments that have been obtained in accordance with the current edition of the NEBB Procedural Standards forTesting, Adjusting, and Balancing of Environmental Systems. Any variances from design quantities, which exceed NEBB tolerances, are noted in the TestAdjustBalance Report Project Summary. Significant / Noteworthy Remarks are noted on the General Remarks and General Field Notes pages. Other remarks are noted on individualtest sheets. Noted deficiencies are not the TAB firms responsibility to repair. Prior to issuance of this report, Deficiency Reports are forwarded to our contracted agent. Warranty is limited to one year from date of this report. Within that time, any discrepancies, ambiguities, or omissions found in this report will be retested, adjusted, or balanced as needed. A written notification will be required. Submitted and Certified by: NEBB TAB Firm: Neudorfer Engineers lnc Certification No: 2465 Expiration Date: December 31, 2008 Certification Date: January 4,2009 (Date completed) Signed and Sealed by: NEBB Supervisor:William G. Neudorfer WLLIAM C. NEUDOFFER OERTIF'ICATION 2485 Exp. l2J3'1i08 UE p f Neudorfer Engineers, lnc. L * {lorliullin(l l-.fl1;irrorrrs *iu:llllo Pdrll$ild Olynrllil OuflrnY Warranty Project; Jefferson Healthcare Warrantv of Services: Neudorfer Engineers, lnc. warrants that the air & hydronic balancing, evaluated during this performance evaluation are operating at the specified levels as documented within this report. At and only this time, and makes no other warranties, stated or implied, concerning the continued performance, operation or safety in the use of this equipment past this time. Neudorfer Engineers warrants the air and hydronic balancing for I year from the date of substantial completion. Neudorfer Engineers reserves the right to correct errors or omissions in the collections of data. Warrantv Procedures: For all warranty items, Neudorfer Engineers requires written request. The written request should be specific on the areas of concern, such rooms, or equipment, and the type of issue the occupants are having. Once written notification is received Neudorfer Engineers will schedule a Technician. lt is recommended that and Owner or A,/E Representative be on site at that time. Voided Warrantv and Additional Charqes: lf a complaint issue is due to a mechanical equipment failure, control or maintenance related, the return trip maybe subject to a service charge, not covered under warranty. Neudorfer Engineers reserves the right to resolve any TAB issue. lf a third party or competing Test & Balance/ Commissioning firm test or adjust any equipment, all project warranty is voided. (This is typical standard for the Mechanical industry, as Manufacture, Mechanical and Control Contractor voids all warranty when a competing firm test or manipulates their systems.) Any return trip to the job site are subject to a service charge and a purchase order will be required before returning to the job site. Document Archivinq An electric file of all test documents will be kept on file until the end of the Warranty period. During that time and electronic copy of the test data will be provided a no charge. Any additional hard / bound copies requested will be subject to a fee. tIj Neudcrfer Engineers, lnc. !iilitttl{r PollliiR{.1 t}lynrl):n Uuurn{;o'u;ullin{l I rrgiriotn; Terms and Abbreviations Project: Jefferson Healthcare AC or AGU Air Conditioner or Air Conditioning Unit Act. Actual ACGU Air Cooled Condensing Unit Address Equipment designation number given on the Control Program AH or AHU Air Handler or Air Handling Unit Amps Amperage AP Access Point APP. Application Arr Anangement AVG Average BHP Brake Horsepower BTU British Thermal Units BTUH British Thermal Units per Hour CAV Constant Air Volume CBV Calbirated Balancing Valve (Circuit Setter) CC Cooling Coil CD Ceiling Diffuser GFLA Correct Full Load Amperage CFM Cubic Feet per Minute CH Chiller CHWS Chilled Water Supply CHWR Chilled Water Return Coeff. Coefficient CP Circulating Pump CR Ceiling Register CRAG Computer Room Air Conditioner GRU Computer Room Unit GT Cooling Tower GU Condenser Unit CUH Cabinet Unit Heater CWS Condenser Water Supply GWR Condenser Water Return DAT Discharge Air Temperature DB Dyr Bulb DD Direct Drive DDC Direct Digital Controls: EMS Control System for the HVAC Delta Difference, net decrease or increase Des. Dia. Disch. DNL EA EAT Economizer Design Diameter Discharge Data Not Listed Exhaust Air Entering Air Temperature Controls and components that allow an air handler to logically utilize outdoor air for cooling as opposed to the use of mechanical cooling. Electric Duct Coil Electric Duct Heater Exhaust Fan Exhaust Grille Energy Management Control System Energy Recovery Unit External Static Pressure Evaporator Entering Water Temperature Fan Coil Unit Fire Damper Fume Hood Full Load Amperage: Maximum amperage a motor can draw. lnstrument that captures air and converts the reading to CFM. Fan Powered Box Feet per Minute Field Report Foot, Feet Fan Terminal Unit Gallons per Minute Heating Coil Pressure Difference across the entering and leaving side of a pump. Thermal overload protection for motors located at the motor starter (starter heaters) Hig h Efficiency Particulate Arrestance Hand / Off / Auto Switch Horsepower Flow Hood EDC EDH EF EG EMCS ERU E.S.P. Evap. EWT FCU FD FH FLA FPB FPM FR FT FTU GPM HC HD Heater O.L. HEPA HOA HP ft,fL4f Neudorfer Engineers, lnc- (:()ilirrlliil(lI IXlirx'Ir:. !;':il!tl0 l'o,llit!nl (llyIrl,:ir ()ltitnt Terms and Abbreviations Project: Jefferson Healthcare HRG Heat Recovery Coil HUH Hydronic Unit Heater HVAC Heating Ventilation and Air Conditioning HWS Heating Water Supply HWR Heating Water Return HX Heat Exchanger HZ Hertz, cycle per second l.D. lnside Diameter in. inches in.w.g. inches of water gauge Kfactor Correction factor to the free area need to calculate CFM. KW Kilowatts LAT Leaving Air Temperature LWG LowWall Grille LWR Low Wall Register LWT Leaving Water Temperature MAU Make-up Air Hangling Unit MBH 1,OOO BTUH MAX. Maximum Flow Requirements for DDC MBH Mega BTUs per hour (1MBH='I,000BTUH) MIN Minimum Flow Requirements for DDC N/A Not Available N/S Not Shown or Specified OA Outside Air OBD Opposed Blade Damper O.D. Outside Diameter PD Pressure Drop. PH Phase PHC Preheat Coil Prim. Primary PSI Pounds per Square lnch RA Return Air RAT Return Air Temperature RF Return Fan RH Relative Humidity RHC Reheat Coil RPM Revolutions per Minute RTU Roof Top Unit RVA Rotating Vane Anemometer -reads air velocity in feet per minute SA Supply Air SAT Supply Air Temerature S.F. Service Factor Schedule Design data obtained from the (sched) mechanical prints' schedule of equipment. SGR Silcon Controlled Rectifier Speed Controller SF Supply Fan SFD Smoke/Fire Damper SP Static Pressure Spec(s) Specifications sq.ft. square feet Submittals Submitted data on equipment (subs) capabilities. Suct. Suction SWG Sidewall Grille SWR Sidewall Register TAB Test; Adjust; and Balance Tach Tachometer Tech Technician TSP Total Static Pressure: Difference between the entering and leaving static pressure of a fan. TP Traverse or Test Point UH Unit Heater VAV Variable Air Volume; box that contains a motorized damper that modulates airflow. VD Volume Damper VFD Variable Frequency Drive Velgrid lnstrument that reads used to read velocity in feet per minute. VP Velocity Pressure WT Variable Volume Terminal WC Water Column W.G. Water Gauge WB Wet Bulb t? f Neudorfer Engineers, lnc. # n Ocrtr'ttll,tr<1 t rrifrrt':tlli; iit:;r!tl,r I'rtrll;rr:r.l ()lyrrrlt;ir (iu,rtrr h'*{.H(ru{Ltl Fast Track Uroent Care Jefferson HealthcarePROJECT LOCATION Port Townsend, Washi noton EXECUTIVE SUMMARY This project has been balanced per plans and specifications using the National Environmental Balancing Bureau (NEBB) standards and procedures. The fans have been checked for fan data, operating amperage, voltage, rotation, RPM, belt tension, alignment, and operating static pressure. Alloutlets have been proportioned to design specifications of unless otherwise noted. AHU-2.1 is a McQuay roof top air-handling unit the unit is operating at g0% of design and is operating at full load amps. EF-2.1 is a roof top exhaust fan the fan is operating at91% of design. Balancing diagrams are attached to this report with outlets numbered for locations fr Neudonfer Enoineers. lnc. Ss{!!l€vFortlold Olyinpia GuumConaulling Engln$0rs Air Handling Unit Report PROJECT: Fast Track Urgent Care Project Jefferson Healthcare LOCATION: Port Townsend, WA PROJECT #: 2008-438 DATE:3/2312009 GONTACT: Rory McCarthy Unit Data Unit Manufacturer Unit Model Number Unit Serial Number Unit Discharge AHU-2.1 / SF Filter Bank Filter Quantity - Size 1 Filter Dimensions - Size 1 Filter Quantity - Size 2 Filter Dimensions - Size 2 Filter Quantity - Size 3 Filter Dimensions - Size 3 McQuay OAHOlOGPAC F8OU50900805 Vertical 2 12x24x4 1 12x24x12 2 24x24x12 SYSTEM/UNIT: AHU-2.1 AREA: Tested By: Lance Jonson Test Date: August 20,2008 Test Pressures OA Damper Pos 100 % Motor Data AHU-2.1 / Exhaust Fan Motor Manufacturer Motor Frame Motor HP Motor RPM Motor Rated Volts Motor Phase Motor Hertz Motor FL Amps Motor Service Factor AHU-2.1 / Supplv Fan Motor Manufacturer Motor Frame Motor HP Motor RPM Motor Rated Volts Motor Phase Motor Hertz Motor FL Amps Motor Service Factor Brake Horsepower Reliance Electric 1B2rC J 1745 230 3 60 8.40 1.15 Baldor 2157 7 112 1750 200 J 60 23 1.15 6.50 BHP Test Data Total Design Flow Total Actual Flow EA Design Flow EA Actual Flow AHU-2.1 / Supplv Fan Fan RPM Actual VFD Sefting Motor Amps Tl Motor Amps T2 Motor Amps T3 5710 CFM 5125 CFM 4270 CFM 3875 CFM 3OOO RPM 52.3O Hz 20.70 Amps 20.70 Amps 20.70 Amps Sheave Data AHU-2.1 / Exhaust Fan Motor Sheave MFG Motor Sheave Model Motor Sheave Bore Fan Sheave MFG Fan Sheave Model Fan Sheave Bore Number of Belts Belt Size Sheave Genter Line Motor to Extend Motor to Retract AHU-2.1 / Suoplv Fan Motor Sheave MFG Motor Sheave Model Motor Sheave Bore Fan Sheave MFG Fan Sheave Model Fan Sheave Bore Number of Belts Belt Size Sheave Genter Line Motor to Extend Motor to Retract Browning 1VP50 1 1i8 in. Browning AK56 H 1 114in. 1 445 13.75 in. .75 in. 1 in. Browning 2AK61 H H1 3/8 in. Browning 2AK3O H1 7/16 in 2 AX37 12.50 in. 2in. 2in. Neudoier Engineers, lnc. i f Neudorfer Enoineers. lnc. * 4 Con$ullingEngindorE So*ttlu-PtrltirxJ Oly'npiu Guarn Air Handling Unit Report PROJECT: Fast Track Urgent Care Project Jefferson Healthcare LOCATION: Port Townsend, WA PROJEcT #: 2008-438 DATE:3/2312009 CONTAGT: Rory McCarthy SYSTEM/UN IT: AHU-2.1 (Cont) AREA: AHU-2.1 Supply Outlet Summary Tested By: Lance Jonson Test Date: August 20,2008 System /,Unlt Area Served Type of Reading Outlet Type Size LxW to AK Design Velocity Design Reading Prellm Reading Final Reading Final Remarks Outlet-01 112 Hood CD 8",|250 185 225 90 Outlet-02 113 Hood CD 8"1 250 170 230 92 Outlet-03 114 Hood CD 8"1 140 110 135 96 Outlet-04 116 Hood CD 8"1 110 95 100 91 Outlet-05 126 Hood CD 5"1 190 220 170 89 Outlet-06 117 Hood CD o 1 190 185 175 92 Outlet-07 128 Hood CD o ,l 120 160 115 96 Outlet-08 128 Hood CD 5"1 100 100 100 100 Outlet-09 105A Hood CD 6'1 70 25 70 100 Outlet-10 105A Hood CD 5'1 115 45 105 91 Outlet-1 1 105A Hood CD 5 1 85 45 80 94 Outlet'12 105 Hood CD o 1 165 180 155 94 Outlet-13 109 Hood CD 12"1 200 230 180 90 Outlet-14 110 Hood CD 12',1 200 30 180 90 Outlet-15 111 Hood CD 12"1 125 180 125 100 Outlet-16 127 Hood CD 6"1 100 100 90 90 Outlet-17 127 Hood CD o 1 75 135 75 100 Outlet-18 118 Hood CD 6"1 150 120 145 97 Outlet-19 123 Hood CD 6"1 75 55 75 100 Outlet-20 122 Hood CD 6"1 150 65 145 97 Outlet-21 106 Hood CD o ,|150 65 150 100 Outlet-22 102 Hood CD B 1 200 300 200 100 Outlet-23 Exam 65-M288 Hood CD o 1 550 290 450 82 Outlet-24 Wait 65-M285 Hood CD 8x8"1 520 300 415 80 Outlet-25 Wait 65-M285 Hood CD 8x8"1 560 45 455 81 Outlet26 Exam 65-M289 Hood CD 6 1 90 165 85 94 Outlet-27 Hall Hood CD o 1 240 130 210 88 Outlet-28 *Wait 65-M287 Hood CD o 1 75 125 65 87 Outlet-29 Chart Hood CD 6'1 150 50 135 90 Outlet-30 Exam 65-M291 Hood CD o 1 150 220 135 90 Outlet-31 165 320 150 91 Totals :5,710 4,445 5,125 90 olo Neudoier Engineers, lnc. {r f Neudorfer Engineers, lnc. Jt a, {}}ti iull ll4l I Iri]iilrr[M ij,$qlth: l-'trlil*r)tl Lll'],ffrFr;l {;Lrrlr Air Handling Unit Report PROJEGT: Fast Track Urgent Care Project Jefferson Healthcare LOCATION: Port Townsend, WA PROJECT #: 2008-438 DATE:3/2312009 CONTAGT: Rory McCarthy SYSTEM/UNIT: AHU-2.1 (Cont) AREA: * Notes Tested By: Lance Jonson Test Date: August 20,2008 AHU-2.1 AHU-2.1 AHU-2.1 U-2.1 / Outlet-28 U-2.1 / Outlet-28 U-2.1 / Outlet-28 U-2.1 / Outlet-28 U-2.1 / Outlet-28 U-2.1 / Outlet-28 U-2.1 / Outlet-28 U-2.1 / Outlet-28 7-Aug-08 7-Aug-08 7-Aug-08 2O-Aug-08 2O-Aug-08 20-Aug-08 20-Aug-08 20-Aug-08 20-Aug-08 20-Aug-08 20-Aug-08 Lance Jonson Lance Jonson Lance Jonson Lance Jonson Lance Jonson Lance Jonson Lance Jonson Lance Jonson Lance Jonson Lance Jonson Lance Jonson #28/29 NOT INSTALLED 90% DRIIVE SPEEDIIS MAX FAN RPM SUGGEST CHANGING SHEAVS FOR O ERATION AT 3000RPM @ 60HZ RESTZE BOTH SHEAVS FOR INCREASED BELT TRAVEL (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. (1) Volume damper is full open. Neudorfer Engineers, lnc. d f Neudorfer Enoineers. lnc, { 4 consulling En0ine{.r $oaltlosFbrtland ofhrpiu Guam Fan Unit Report PROJEGT: Fast Track Urgent Care Project Jefferson Healthcare LOCATION: Port Townsend, WA PROJECT #:2008-438 DATE:3/2312009 CONTACT: Rory McCarthy SYSTEM/UNIT: EF-2.1 AREA: EF-2.1 Exhaust Inlet Summary System, Unit Area Served Type of Reading Outlet Type Size LxW ,D AK Design Velocity Deslgn Reading Prelim Reading Final Reading Final Remarks lnlet-O1 112 Hood EG o 1 350 325 315 90 lnlet-O2 1't3 Hood EG 8"1 70 70 70 100 lnlet-03 114 Hood EG 8"1 40 60 40 100 lnlel04 115 Hood EG 6"1 410 225 240 59 lnlet05 116 Hood EG 10"1 30 30 30 100 lnlet-06 117 Hood EG 8"1 75 40 70 93 lnlet-07 120 Hood EG o 1 290 115 260 90 lnletO8 120 Hood EG o 1 50 40 50 100 lnlet-09 125 Hood EG 8"1 200 100 195 98 lnletl0 111 Hood EG 10"1 200 0 190 95 lnletl 1 110 Hood EG 10"1 215 90 195 91 lnlet-12 109 Hood EG 12"1 400 170 370 o2 lnlet-13 124 Hood EG 8"1 370 210 360 97 lnletl4 122 Hood EG 1 0x6"1 145 70 140 97 lnlet-15 105A Hood EG 7"1 120 240 115 96 lnlet-16 105 Hood EG 8"1 410 280 400 98 lnletl T 106?Hood EG o 1 50 45 45 90 lnletl S 65-M288 Hood EG 6"1 225 175 220 98 lnlet-19 65-M289 Hood EG 6"1 50 35 50 100 lnlet-20 Hall Hood EG 10.1 50 45 45 90 lnlet2l 65-M291 Hood EG 6"1 140 110 130 93 lnlel-22 380 230 345 91 Totals :4,270 2,705 3,875 91 o/o * Notes Neudoier Engineers, lnc. q r _ T - E - T - - ] W * T 1 ' r " E > \ g f c a i l i a = l l I E 3 3 l F : * ; + t E i ; E t { i I I : a E f i ! ] ; 4 i r ; f r ; s l i + : l l o ? [ . 6 E i : T 5 " - ! ! ? : r r h l H 3 _ i _ n r . F i i l + E $ a ; i F l i E F E F ! o o z f r o - E o z I I F I d E a t I I ? d E " l " t E , - E E T n f 3 , F \ i \ x o F F I F f , E t ! $ a I I $ I B H : * { l q 1 3 F = f l = E E i H E I d E l e i + f : E e i i E i € a g 9 ; r I E d F E E E s F l c i E . ' F s g E : L 6 = e 6 i I E ; x g r E e c a g 6 : : a E ; $ i a i * 9 = F 9 3 I I n = o o t \ ) - q # E * E F = y F A S T T R A C K U R G E N T C A R E P R O J E C T J E F F E R S O N H E A L T H C A R E D l t r i f f i l u # r F t w , - 4 4 S # I T N E a H " . . - - r ; i i E : r U l E : ! a n 6 i i E E i a t c ! E l " E : e a i g ; l i i E " F E I B t t c f l [ t ( T u i t t u I A t n l S t L t I Y \ i l o ; 4 - ' t l B w A 9 6 3 6 8 8 3 4 S h e r l d a n A v o P o r t T o w n s e n d D r l . - - - - - M A I U f t r h F P S i . t u - I t I 6; f f i NU M B E R E D NOTES @ wrr'r'mmwm rnd ft dffi ralz'MNM. <' i ) orsrwxru - coilffim 0 ilMm M {lm ffiT <6 mowrooe N. Wf,MUtr @ mvnm o NA 5lire +58*!HiicE r igr!.t i I!Gi F o lu 1 o t o ut x o F z l!o tr l Y o x F F a $bgElIl EilIl .1llll -:t ig-TECHANICAL FLOOR PLANMffiMffi SH E E T NOTES I I I l 1 CO R R co R ! i 6r - Y 3 1 2 1 ffimM10'M src&@MEmrc (MD& W H6m[) MR C O N W. @ !1 i l T t N C Ii { i 8 # f f i lF . - - - c0 N T R 0 i _ s( f , s Dt l v r N c A $t r f f i u f f i r c M l m f f i l m 3. @A ilSAIM AR Uffi F{ffi. INil AD ff i i l s f f i * w H P A I m , fM d S I O ' o f f i W t r U N T 1 2 E rcre fd ffi EA ilEqflT TR W. dM S T M A T N C f u @ D ff i E f f i & N E M d 6 E @ M si l c l 1 M N n t d f r & m d r u CN ffi1ffi Ab NFT [6 S @r@bnNilru@REffi Mf f i B M M M M M + I ' *@ U Y W M R N r u ff i B m mitmCHAM M& D l m E € M A Y M f t f r E MN EntO, @d 0t6 T0 tr ll M [ A T f r E W O F c m M I +a Nil.J"^ 'e ult[oe@@@oBE-c o 'o F o c o cult()t F J u.t -z,o o t UI L I u DN 14. k@ffihMhd.Dhtu&htu*@,aidbhffittu.@*M3.G !.;o o €F o tJ OF F i C E trNU M B T R E D NO T I S (D ,* ,* , L nn w n o' * *, <? > co r u sa r * gm q <3 > zm r nm m r co n r u - tr N N G HO I VA E R RS A I <i > rr w r rc n r c ww r - mE m r u r c d Y sG m m r0 ' N m ff i m ot E f , d l0 EP A EG A M M UM S (P M E D n Sf t r 4 UF @i .ST ds h M o O fl o * Y e o w I 9? 1 r y ) M202 07,/E5/3008 07:1$ FAX ;601E51481 JE ConEtructlon B oor Letter of Transmittal Septeruber ?8,2007 ll&skington SUfe @ment oJ Health I Jdfersnn Flealthcar+ Mr. Vic Dirkeon 8S4 Sheridan $t Ft Townsend,lfifA gEI68 L:snstmck:Orl Revier+ s*fvirreS 3tt Isi;r+t Rord BE T*rrr*r*t*Fr WA F8501 PO Box 4?85? Olyropi+ Wa*inElon 98504-7ff 52 www.doh.wagovlcrs tcl.16&?36-?944 fsx. 36S.?36-?9$l Froject Infar KeyPcople: .Assigned DSH Rcviewer Feciliry Administratsr: Axchitect / Engineer: Sprinkler / ftntractor: O$rer: cRs# 9467 Jeftrsort He*lthsflre Chepter ?46-3?0 WAC Hospitels Fast Traak Urgent Care Prttjeet Mrtthew Crmpbell sratthew. cmnpbctl@doh. wa.gav Iefferson Healthcare Mr Vic Dir*son 834 Sberidan 5t Pqrt Townsend, ltrA 98368 i36$i 5$5-??os Rice Fergus Miller MrBob Rhees 2624& St Ensmertoro WA 98337 {360) 371-52S7 bmi ller-rhees@rfarch.com N/A N/A Project lo*ation: Lo**l P+rmit #; Facility Csntast: Buitding Dffrcial: 834 Sheridan St Port Townsen4 W498368 Jeff€rssn Heal&csre Ms DailaMichels€fi 834 Shsidffr St Port Townemd, SfA 9E36S (360) 3S5+200 dmichaelser.r@igh.trg Cify ofFonTorrnsend Jan HoptubE€k lEl Quincy St ST'E 301 PortTownsen4 WA 98368 (360) 379-50S7 jhapfenbeck@si,psrt-tolfi l$efi d-rrt-t+ H/A Copie Tot tr Local Building Offrsial: trl Wrhington sei*P*kcl, Fire Fr+tection 5ur*al* El At"hit*"t / Engine=r: R.i* Fergus Millertrtrtrtr Fire Alarm Csntracton OErcr:N1A DOH Ctrild Eirft Canttrticcnsing DOH ${fiss tf Aeas*rlffiadrtio$s & Hss. Car* $urycy DOII QfficE of Hcrlth Care SurueyDSHS, , Div. Of n{Icolt$l end $ubsiatice Abusc DSHS. , Aging & Adult ServicesAdminis:ntion L&I, Bill E€tnot5 El*tical SectionL&f, , Ffl$tor;r Asc$tbled Snuchres Sub.gots{ctor: lrU,{L SuFContractor: IVA Othcr: CRS File Page I of?Plan Review Commentr for Frojcrt *i9{6? 07/15,i1008 07:1S F"{X S601S51421 Jefftrson Healthcare chapter ?46-320 WAC Hospirals F'*st Tr*+k Urgent Care Prajeet JH Constructlon E oor Memo: - Authorized to Begin C*nsfruction - Fire AI*nn Deferred The docunents hrve been rrevicu.ed snd c.snstructiorr s*u hegin with*ut del*y, snbis*t t* construition pennitting from the local btilding officinL The sttmprd approved copy of th* dscnmentr rb*lltr krptavailthlt tt rite fcr surueg and intpectian staff. TLe losfll huilding s*lei.*l ir responsihle for buildiag construction permittlug nnd occupflnry, Pl*ase notc the following; ' Any changes (incl. thange orders or nddend*) during construction shall bc subniffed to the department for Frriew of compliance rith rpptic*hle c.ade. ' Apprwd for liff'nsure crnnotbe gircn nntil *lI ronstnrctitn dncuments *nd *hang* have becu reviewerl and apprrved. ' Proceeding with constriretian prior to retolving the rtt*chrd commentr B'ill *ourtirhte facility *cknrwledgement thatyon sr* proee+ding atyour owq rirk r ff we do not mceive written resFsn;ea to the sttachcd commenr$, we will automatierlly sehedule* sitr inspectirn. r You must notify the departmeutrhen eanstruction i* compleir. either by the includednoffication of constructicn compl*te {pinh eard) sr by completing th form on the CRS wehsite. Additiou*l instmctisns mry ue printed on the pinlr card. lilhen we reesiventtifieatiotrryGvill natify DOH Office of Heallt Csre Suryry thatyou [rv+ completed the rsview Fros,Bss and nre ref,dy for licensing, ' Fincl lit*nsing epproval uay be ruhjert tc a sit* inrpcction by IICH Oflice of l{ealth C*rr survey to yerify *ampliance with Haspitar ricenring regulrtions. Page? of 7 Plan Rcview Cqmment$ f+r Frojeet # 946? 07,i25l2008 07:1S FA-X 1601851411 JE Constructlol @ oor-) Data Certificate: The drts aboye is bfls€d on the informtticu presenfed tu eRS, Any eharge in the fncilityor faciltty program that clilses the above inform*tion to be ineorrect i* +rhjtd to r*view by CRS. Approwl for *ouatrnetian is ust nppruvrl for licensure. A copy of the frcility d*t* certificrtc rilt be s€nt to the lieen*iug rgency. tx|0{}33 EiYe" nun Estimnted Date af Omupaney:Marrh 1$,Ztllt8 J*iff*rt*u lltalthcnr*FaciliryNsme: Sit* Addr*s*: D0HFacitityID; Critical Acccss Fncility:t34 $herid+n St Port Ttwntend, \H* 9836* u)rd F{ltr F. )rh HU{trrlFl{ Oceupancy Group: B Cattstru*tion Type: 2-B Applicable Ccde: Numtrer cf Beds: Current:Added:Resrcved:Totsl: Automntic Fire Sprirrhler $ystem: fl Yes Ellto T4* Autamatic Fire Alilrn System: EIyos n N" ' Comparbnent*tion req'd:fflYes *F{s SmokeCtxrtrol SystemProvided: il Yo [No Specid Delayed EgrEsc CanaoL fi Yes Ellt" Ls€*tion: Certificate of Need Required: I Yes EXtto CON Approvnl Grented: CONNumber: flYes flNs bldFdFfUE 4 lFjfr EriHFztrI-l i,J H9 H r.l Numherof units;Hvate oceupdrtry:T$o person occupancy: Based on size of rooms used fgr sleeping Eascd on siae of cornmon rooms Maximum allowahle lieeasable beds: Resideots Reeidc lts Qualifies for Assised Living Fmding Fragram tr Yes ilNo Numbernf qurlifringrmim: {r1I-]Ho E, Page 3 of?Plgn Review C+*uncnts for Project# 946? 07/15,/200$ 07:20 FAX *60*851421 JeffFrson Healthcarr Chapter 246-32Q WAC Hospitals S'**t Traek Urge*t Cer* Pr+ject JE e0B6tructl0n E oo+ PIan ReYierY Comments L *i-a'il ,T =E:EESR tfE{LETGREU { 17I EII E Pcovide a campleted c$Fy ofdrc facilitfs Infectiee Conb*l Risk Assessmest (ICRA) for tlris projeet. This assessfffint te$Id ideirtify riskl ffid desuibc p'avisinn$ frlr infsctiofi conksl and sdcty of *e facility's seaupants dwhg any reaovation sr nelry construction projects, Eflrh ICRA must be individually tailored ta fit each phre of the project The designer mr.st incorpmate the requirerrents of the ICRA intc,the constuction docunenE. and include the locations of the following, as applieabk: . Ternporary barriers, (temporary baffiens are noted 0n A2) . Anterouns, r Negative prEssurE outlets, r Contactoraccess, and r Debris m,moval. Assesfflerrf$ that are incomplete sr do not sd&ess the specific project $ill not bE ap'proved Conetuction Review SHffis *eilable to meet with the facility, #sigu taam *nd contsctor t* develop a plan. C,ontrct your assignd DoH rwieram fcr mne infomration. wAC 246-3204S5(1) and wAC ?4f-320-505{2XaXii} Approved 9ll?,lfr7 - Based on informntion presented in fte congtruction documents nnd follow-up key plrn, and facitity infection ccntrcl permit received 9n1ft7, The functional progrflm deseribes shnring support facilities with the emtrgencyroorn. Describg how medications and soiled firnctians will be r*ilized for tbs new Fsst Track area when sharing thme support areas with the Emergency Departrnent which is acr*ss the corridcr. It aprpears tln intmtion is to have staff cross back *nd forth through an existing waiti*g area. WAC 246-3?0-s*5{2gai Approved 9ltZlIT -Based on cut sheet rereived and phone csnversntion urith Dana lUichelton this d*te, Omnicelt syrtem ehatl be provided at $tor*gs area far medication, $upplie* used in this.rrca will be disposrble to fnllest extent practicll Fago 4 of7 PIan Rflview Comments for Project # 9467 07/25/2008 07:t0 FA-X 3601851421 JE Con6trust10tr E oot Provide a descripticn in dre firnctional praggamto describe how services urill be provided if AlternateA-2 is cenpleted- The drswings sh*w tbe Tr*r:rat reom and Soiled Utility rrorn being +loscd during th* renrvati**, WAC ?46-320-sft5fiXa) Onritted 9ltLl*T - Altemrte A-? omitted liom s*opi of work. Frovide Exam 65-!vI289 with +ittrer negative cr po:itive presst*ieatirn. The definitian of presswization is 70 CFIvI per lltrAC 246-320-Slfi{a or bi. {3heet lvIZS?} wAC 246-320-40s{9[c[ii} Approvcd 9!l?l*7 - Based rn.reviscd mecheniell shcet M202 datd 8t27!01. Provide Tamper-proof reeephclw Wciting #65-M38?, Exams #65-h,flf$, #65-M?Sg & 65-M29I. {Sheet E20t} WAC ?46-3?0-5?5, Table 535-5 Approved 9ll2lfr7 -Based on Addendn #l d*ted *f?,L107. Provide I oxygen and I vacuum outlet ts eash Exam room in lhe fast ffick unit. WAC 746-3?A-525, Table 525-Z {Emergency sxam rooms} Approved 9llUX? -Besed on Addenda #l da*rd 9n1fi7. Rwi*td drrwingP?O2 provides oxygcn rnd vrtuum outlcts *t eJlam rooms *nd ne* mdie*l g*f, aotrG vrlre rcrving the arc*. Note: Thk building is un-sprinklercd Note: Portabla fire ertinguishers shalt be pr*vided. ia eve*y b**iness occupany in aecordanee with NFPA lSl - 9.7.4.1. It is noted a Fire Extingtirher cabinet is located in the main citculation t$ea of the Fast Track Unit as this area daes not have fire sprinklers. NFFA 1S.3.5 El Two ctmplete plans and specific.ations for the fire alarm system install*tion ar modificati*n eh*ll be srrb.rnitted for review and approval prior to ay'.e* installatian. The deparhrent ressrvis tre right to dcfer plan review and irupecrions tlr ths local authority having jurisdiction {A}II). 'd=E .hqd,Etr.AEE.JogGu4Z J 4 5 6 7 Page 5 of? (Continued n*$ p*ge) Plan Review C.*mme,nts ftr Fraject # 946? 07/15/2008 0?:20 FAX ss018514t1 JE Constructlotr E ooo o*n o{FE ts4og A-s thic arnen of the buildingr*mrius trrprinkled, submit compreh*nsiyr fire :I"* drawingr for ihe patient *rre areas cf tLis scope sf woril Provide fnllbafirry cal*ulatiou en{ technicrl iuformetisn *s ref*renced shbve. Campftance *r* rlre coF?m€.fitr absve Fre+'i&d 6y r&e Dcpar*ne w of l{ealt\ Corqrcrrrcfi'or .Re*ierrr Jbr+recs, Ere #€6er,r*Drjbr #trs$6:i,ig ra maerthe requiremenu qf the *ppticnbte li&&ring rag*#ierr frittrrd in c*e wi*itigtsn s,are rdntintrtrative code a*d esseeiawd *,f***c*' iniesecammcnts dp not Felieve the f+ility fran rlze respons$r?i'y ta n*t the req*iiitar^ olury ather appttaaslefederal, sme *r loca! regulatiow.In cle event of cor{ficts betwer'r' others'wisdutions end tiese r+ritre * ,oiiri, tto irii*Wflinti ,pity. , {#7 Co*tinued) Flans and specifieatipns shall include, but nct be limitsd ts, a flacr plan; locatiau cf allI alarm-initiating and alarm-signaling devices; alarm-coatrolaadtouble-sign*Iing : eSuipment: anmrnciation; pourere.onne*tiatriUutt*.y calenlations; eenductl ffFe ald , sizes; voltege drop ealculatians; aarne, address, aud phane numbs ef the agensyi rtceiving ofF-pre.mise+hawluission of alarm; and th€ uranufacfiuer, modeliliiabers, : and listing infurnnation for all equiprnen! devices, and material*. In$oqFlete ulanc; an-d, sgeeiticatioFs rrill be f,etrrrted wiFout reyiew. Plans and sptecffiEy *j submitted separately froro constructioir documeuts aruingth€ coastructirn nf thei q*j.-*. , For srnall renovation projects in which derriees ar+ only t* be relomted or veryi fsw devi+es are to be added, Frlide trva plans that shows the telwation of devicss, whi?h may be submitted for review in lieu of the above requirements, This informatiorr' san be included on thc electrical ar architectural plaus. verify with Departnent staff toI detsrnine if th.e scop€ cf yoru project meets this critsia. Seotion g0?.f, htemational Fire Code Fage 6 of7 Plan Review Commerts for Project # 946T City of Port Townsend Development Services Department 250 Madison Street, Suite 3 Port Townsend WA 98368 360-379-5095 Fax 360-344-4619 REVISION TO BUILDING PERMIT #O Revision # OWNER:ADDRESS' g3T S{.et,^St Total Value of Revision: $)fc Pr Impervious Surface Change? ! Yes_ FNo Revisions require 2 sets of plans and a written scope of workthat fully describes the proposeC change plus any additional information that will be of assistance in issuing your revision. If your plans were stamped by a design professional, all revision submittals require a stamp with a wet signature. Be auare that changes to the existing approved plans may also require yqg to revise your original building permit application (lot coverage, impervious surface, structure square footage, etc.) and energy code documents (changing windows, heat source, etc.) to conform to your proposed changes. Scope of Y \n E uU!5 I (7,Y--s FFR 1 e :rrna /7 /)- t \,/ F.\ /.ll v /1 ctt /,I /\d Date "L)| 'o/Signature OFFICE USE ONLY: Submittal date: 2-'Two sets of plans for revision: / Approval of engineer of (if original plans engineered): tr Yes n No n NA P:\DSDtDepartment Forms\Eluilding Forms\Appl ication-Revis ion.doc 'J Receipt Number: BLD07-170 948319202 Plan Review Fee - Re.rision $50.00 _ _ ___j19.00Total: $50.00 $0.00 07-0953 07-o715 07-0953 07-0953 07-0953 07-0953 CHECK 11t06t2007 0811412007 11t06t2007 1110612007 1110612007 11t06t2007 65947 $1,665.75 $250.00 $832.74 $10.00 $4.s0 $33.32 BLDOT-170 BLD07-170 BLD07-170 BLD07-170 BLD07-170 BLD07-170 Building Permit Fee Plan Review Fee Plan Review Fee Record Retention Fee for Building Permit State Building Code Council Fee Technology Fee for Building Permit $ 50.00 Total $s0.00 genprntrreceipls Fage 1 of 1 ffKrazan & Asso ctArEs, /NC CEOTECHNICAT ENG,NEERING T ENV,RONMENTAI ENG,NEER,NG CONSTRUCTION TEST'N6 & 'NSPECT'ON June 27,2A08 KA Project No.: 106-08084 PermitNo.: Ms. Dana Michelsen Jefferson Healthcare 824 Sheridan PortTownsend, WA 98368 REr Jefferson Healthcare Fast Track Urgent Care PortTownsend, WA Dear Ms. Michelsen: In accordance with your request and authorization, the following test data are presented on the following reports, which are enclosed: May 13 Cylinder Repoft No. 27613 Referenced concrete reports and compressive strength data will be mailed following 28-day tests, if applicable. If you have any questions, or if we can be of further assistance, please do not hesitate to contact our office. Respectfully submitted,z^4 Penn Seely, Laboratory Manager Peninsula Division PS: mds Enclosures cc: City of Port Townsend/Tom Miller (e-mail) With Offlces Serving The Western United Stotes E c JUL - 3 2t)OB CEIVE CITY OT PORT TOWNSEND DSD 20714 State Hwy. 305 NE, Suite 3C o Poulsbo, Washington 98370 r (360) 598-2126 o Fax: (360) 598-2t27 Arazan c As5(,ctates, tnc. ^tJf. 4 utate nwy. lruS N.E. tiufte uu,vvA vuu/u (3our-cv6-ztzo Profect Ho. 106'08084 cg. code P14483 pour Date 5-13-2008 Reporr No. 27619 weather CLOUDY Jurlsdlctlon CITY OF PORT TOWNSEND permtt No. BLDG-07-'a7O prolect Jefferson Healthcare Fast Track urgent Care Engrneer Location PORT TOWNSEND Architecr ctient JEFFERSON HEALTHCARE contractor FISCHER Fleld Data Supplier FRED HILL Goncrete X Mortar Prisms Grouted Grout Ungrouted Site Mix Plant No. 5 Flex Beams Other Tlme 7:4Q Truck f 73 Tlcket # 15461 e/o Alr Slump 2.25 Gonc. Air Temp. Temp.(F) (n 65 54 Unlt wr. Reported Batch Data CementTypo l-ll Dealgn Actua! X Mtx No, M4060.1 Csm.lbs. 656 F.Ash lbs. c. ass. tbs. 1912 C. agg.lbs.2 C. agg.lbe.9 Sand lbs. 1859 Water 189 Admtxture POLY 46 OZ orhsr POZZ534 12 OZ Alr Ent. (ozlcwt.) aceme Footings Walls Columns Grade Beams Slab/Deck Slab Pltlngs Other crras CONCRETE PLACED BY WHEELBARROW TO 2 SI.AB INFILLS AT MAIN FLOOR URGENT CARE AREA. Remarks MIX MECH CONSOLIDATED. HAND FIN|SHED. SAMPLED AT ONE YARD WIC ,27. Water Added on Job (gals.) 0 lnspector LOWELL DAVIS Revtewed t W E E E ASTM C138 ASTM C173 M C143 Other cl064 c31 Laboratory Data Gyl. TestGode Date P14483- 05t20t08 Pl4483- 06/10/08 P14483- 06/10/08 Pl4483- 06/10/08 P1 4483- P14483- P14483- P14493- Dia Design Strength 4000 Length Max. Comp,Area Load Str. (psl) Set #12.53 50445 4,030 12.59 65510 5,200 12.59 65925 5,240 12,59 65250 5,180 Date Speclmens Rec'd, 5-14-2008 Lab Test Method ASTMC3g EASTMC1O9 trASTMC617 tr ASTM C1231 trASTMC1019 tr Other X Compresslve Flexural Tesled BreakBy TypeAge Dlm.7 4X8 28 4XB 28 4X8 28 4X8 AC1 CJA 1 CJA 1 CJA 1 Remarks FR94473 Results Reviewed ", % CodesforBreakTypes: 1,Cone Date Review ea ?1. Jt ^^- , Test Results X Conforming Non-Conforming I ^ 2. Cone & Split 3. Cone & Shear 4. Shear 5. Columnar (Split) -\ ffiw &w '4.1i; :ii i it I i: iii !i: i ii',i Iit : :i1 I i 3(]* x,t c:r1uF4r}$ 7 May L, 2008 Leonard Yarberry Development Services Director City of Port Townsend 250 Madison St, Suite 3 Port Townsend, WA 98368 RE: iefferson Healthcare, Fast Track Urgent Care project Dear Leonard, Attached are two signed copies of the revised Fast Track Urgent Care project for Jefferson Healthcare. The significant changes between the set you have on file and this one is elimination of the alternates and inclusion of some last minute existing conditions. lf you have any questions please give me a call. Our site superintendent for Fischer General Contracting is John Lee (cell phone 360-689- 6422, job shack 360-379-99761. He will be available to pick up the stamped set and would be an excellent resource should you have any questions about the project. Thank you Regards, !6) CLS{* i*D{fiti*(3*r6a-ilItt** {vry '* u* c: *:#!.{* ucg It rl! 1]i{ d{a* ils {N} xiEff?t t51}6it:{fc {!} utr.t : o i,,Lls *$tilu\tC,1-* Bob Miller-Rhees Architect, LEED@ AP l,iA,'l - ? 2n0B n E CITY OF PORT TOWNSEND DSD iGEI]V E D"t* I"ro*afffi ExpirationDate104/95/ il Re-issue o"*{]Il l*t" gto""lf-.* LuutA"tiooffi .:!{:: .=;::::; :f$ '*:{gW-!€:A:€l st"tus Datefi66ilDilF Stahrs ElFlstee? hcjectl{ane Orerdale Eryire? f- Government?T Date lppt*ffiryp"ffi Date Subrilitrsa losrfl a/200? T ec!::ricalty Co*pt*t* f-- Parent# | Po.*t,*ffiSitrAaA.""rffi i0/05/2007 0( q'7 5 / Co -L5' LJ'-E> QrtwL-;e t-{n qDaua va;" l3?4 Jefferson Healthcare Chapter 246-320 WAC Hospitals Fast Track Urgent Care Project Memo: - Authorizedto Begin Construction - Fire Alarm Defened The documents have been reviewed and construction can tregin without delay, subject to construction permitting from the local building official. The stamped approved copy of the documents shall be kept available on site for survey and inspection staff. The local building official is responsible for building construction permitting and occupancy. Please note the following: . Any changes (incl. change orders or addenda) during construction shall be submitted to the department for review of compliance with applicable codes. . Approval for licensure cannot be given until all construction documents and changes have been reviewed and approved. . Proceeding with construction prior to resolving the attached comments will constitute facitify acknowledgement that you are proceeding at your own risk. . If we do not receive written responses to the attached comments, we will automatically schedule a site inspection. r You must notify the department when construction is complete, either by the included notification of construction complete (pink card) or by completing the form on the CRS website. Additional instructions may be printed on the pink card. When we receive notification, we will notify DOH Office of Health Care Survey that you have completed the review process and are ready for licensing. . Final licensing approval.may be subject to a site inspection by DOH Office of Health Care Survey to veriff compliance with Hospital licensing regulations. PageZ of7 Plan Review Comments for Project # 9461 .) Facili Data Certificate: ) 000033 X Yet flNo Bstimated Date of Occupancy:March 10,2008 Jefferson HealthcareFacility Name: Site Address: DOH Facility ID: Critical Access Facility:834 Sheridan St Port Townsend, Wa 98368 a frlg/3 t'{ Fl U fr Fl Fl Occupancy Group: B Construction Type: 2-B Applicable Code: Number of Beds: Current:Added:Removed:Total Automatic Fire Sprinkler System: ll Yes X No Type Automatic Fire Alarm System: I Yes Ll No Compartmentation req' d:XYes LlNo Smoke Control System Provided: [l Yes LJNo Special Delayed Egress Control: [-l Yes XNo Location Certificate ofNeed Required: [l Yes XNo CON ApprovalGranted: CON Number : LJ Yes L_lNo frlEI q3 '4a ti l-tHFz=f-l i FTU fre Number of units: Private occupancy: Based on size of rooms used for sleeping Residents Based on size of common rooms Residents Maximum allowable licensable beds: Two person occupancy: Qualifies for Assisted Living Funding Program I Yes nNo Number of quali$ing units: (n f-1F z The data above is based on the information presented to CRS. Any change in the facility or facility program that causes the above information to be incorrect is subject to review by CRS. Approval for construction is not approval for licensure. A copy of the facility data certificate will tre sent to the licensing agency. Page 3 of7 Plan Review Comments for Project # 946'7 Jefferson Healthcare Chapter 246-320 WAC Hospitals Fast Track Urgent Care Project Plan Review Comments 2E o oaa oz !9 eo.o. E ! o E Q 1 Provide a completed copy of the facility's Infection Control Risk Assessment (ICRA) for this project. This assessment would identi$ risks and describe provisions for infection control and safety of the facility's occupants during any renovation or new construction projects. Each ICRA must be individually tailored to fit each phase of the project. The designer must incorporate the requirements of the ICRA into the construction documents, and include the locations of the following, as applicable: : ::t::x,outt"tt' (temporary barriers are noted on A2) : ::il::;"Ti:[;:"" r Debris removal. Assessments that are incomplete or do not address the specific project will not be approved. Construction Review Staff is available to meet with the facility, design team and contractor to develop a plan. Contact your assigned DOH reviewer for more information. WAC 246-320-405(1) and WAC 246-320-505(2XaXii) Approved 9ll2l07 - Based on information presented in the construction documents and follow-up key plan, and facility infection control permit received 9111107. The functional program describes sharing support facilities with the emergency room. Describe how medications and soiled functions will be utilized for the new Fast Track area when sharing those support areas with the Emergency Department which is across the corridor. It appears the intention is to have staff cross back and forth through an existing waiting area. wAC 246-320-s0sQ)@) Approved 9ll2l07 - Based on cut sheet received and phone conversation with Dana Michelson this date. Omnicell system shall be provided at storage area for medication. Supplies used in this area will be disposable to fullest extent practical. Page 4 of1 Plan Review Comments for Projeit # 9467 +!no a =EchoolZ>otrg<tEAJooo()< J 4E 5 6EI 7 Provide a description in the functional program to describe how services will be provided if Alternate A-2 is completed. The drawings show the Trauma room and Soiled Utility room being closed during the renovation. wAC 246-320-s0s(2)(a) Omitted 9ll2l07 - Alternate A-2 omitted from scope of work Provide Exam 65-M289 with either negative or positive pressurization. The definition of pressurization is 70 CFM per WAC 246-320-010(a or b). (Sheet M202) wAC 246 -320 -40s (e)(c)(ii) Approved 9ll2l07 - Based on revised mechanical sheet [{202 dated 8127107. Provide Tamper-proof receptacles Waiting#65-M287, Exams #65-M288, #65-M289 & 65-M291. (Sheet E201) WAC 246-320-525, Table 525-5 Approved 9ll2l07 - Based on Addenda #1 dated 9121107. Provide I oxygen and 1 vacuum outlet to each Exam room in the fast traek unit. WAC 246-320-525, Table 525-2 (Emergency exam rooms) Approved 9/12107 - Based on Addenda #l dated 9121107. Revised drawing P202 provides oxygen and vacuum outlets at exam rooms and new medical gas zone valve serving the area. Note: This building is un-sprinklered Note: Portable fire extinguishers shall be provided in every business occupany in accordance with NFPA l0l - 9.7.4.1. It is noted a Fire Extinguisher cabinet is located in the main circulation area of the Fast Track Unit as this area does not have fire sprinklers. NFPA 3 8.3.5 E Two complete plans and specifications f:or the fire alarm system installation or modification shall be submitted for review and approval prior to system installation. The department reserves the right to defer plan review and inspections to the local authority having j urisdiction (AHJ). Page 5 of7 (Continued next page) Plan Review Comments for Project # 9467 !no =>=Eg!93E94EgoooQ< ( #7 Continued) Plans and specifications shall include, but not be limited to, a floor plan; location of all alarm-initiating and alarm-signaling devices; alarm-control and trouble-signaling equipment; annunciation; power connection; battery calculations; conductor type and sizes; voltage drop calculations; name, address, and phone number of the agency receiving off-premises transmission of alarm; and the manufacturer, model numbers, and listing information for all equipment, devices, and materials. Incomplete plans qnri snanifinoli^ns will be rafrr rnad wifh nrrf rarriarrr Plans and specifications may be submitted separately from construction documents during the construction of the project. For small renovation projects in which devices are only to be relocated or very few devices are to be added, provide two plans that shows the relocation of devices which may be submitted for review in lieu of the above requirements. This information can be included on the electrical or architectural plans. Verify with Department staff to determine if the scope of your project meets this criteria. Section g\il.l,International Fire Code As this area of the building remains unsprinkled, submit comprehensive fire alarm drawings for the patient care areas of this scope of work Provide full battery calculations and technical information as referenced above. Compliance with the comments above provided by the Department of Health, Construction Review Services, are necessary for this facitity to meet the requirements of the applicable licensing regulations found in the Washington State Administrative Code and associated references. These comments do not relieve the facility from the responsibility to meet the requirements of any other applicable federal, state or local regulations. In the event of conflicts between other jurisdictions and these written comments, the most stringent shall apply. Page 6 of7 Plan Review Comments for Project # 9467 ) Thomas L. Aumock Consulting Fire Code Official 2303 Hendricks Street, Port Townsend, WA 98368 (360)385-3938 Email:taumock@cablespeed.qom Cell:(360) 643-0272 TO: FR: DT: RE: CC: PLAN REVIEW MBMORANDUM Jan Hopfenbeck, Plans Examiner, Development Services Department Tom Aumock, Consulting Fire Code Official 14 September 200'7 BLD07-170, Jefferson General Hospital, 834 Sheridan St., Urgent Care Clinic Mike Mingee, Fire Chief, East Jefferson Fire & Rescue 0 {-/ ff)'v This consulting Fire Code Official is in receipt of the set of plans and specification for the referenced building permit application from your office for remodel of an area just adjacent to the emergency room waiting area, for an urgent care clinic at Jefferson General Hospital, F indinss & Determinations: l. The proposal was examined as a Group B occupancy adjacent to the Group I hospital functions, and; 2, An automatic fire suppression system (sprinklers) is not required for the structure under I.F.C. Section 903, and; 3. An automatic fire detection alarm system is not required for this occupancy under IFC Section 901.2.1 of said Code as the clinic occupancy load of less than 300 persons, however, the proposed remodel shall not interfere with the operation of any installed automatic fire detection system devices. There is an existing notification horn which shall remain operable, and; 4. Fire extinguisher sizing and placement shall meet or exceed IFC Section 906 and NFPA Standard 10, which normally requires a2-A:1O-B:C minimum rated flre extinguisher at the exit(s), and; 5. Should the Hospital decide to include sprinkler protection and/or fire detection system additions from the existing systems, a formal review of such expansion shall be made by the Fire Code Official. 0.5 hours time was consumed in the review of this proposal, which included site inspection It is the recommendation of this plans examiner that the subject permit application be approved subject to the aforesaid stipulation of approval. C:\Documents and Settings\jzimmer\Local Settings\Temporary Intemet Files\OLKF\BLDO7-170 Jeff Cen Urgent Care Clinic.docg/14/07 /1*-'-') Letter of Transmittal October 1,2007 Washington Stnte Department of Health Construction Review Services 310 Israel Road SE Tumwater, WA 98501 PO Box 47852 Olympia, Washington 98504-7 852 www.doh.wa.gov/crs tel.360-236-2944 fax.360-236-2901 Project Info: Key People: Assigned DOH Reviewer: Facility Administrator: Architect / Engineer: Sprinkler / Contractor: Rice Fergus Miller Mr Bob Rhees 262 4th St Bremefton, WA 98337 (360)27t-s287 bmiller-rhees@rfarch. com N/A Other:N/A Copies To: X Local Building Official: X Washington State Patrol, Fire Protection Bureau X Architect / Engineer: Rice Fergus Miller n Sub-Contractor; N/A Sub-Contractor: N/A Other: X cRS File Building official: n!n X L&I, Bill Echroth, Electrical Section tr L&1, , Factory Assembled Structures 834 Sheridan St Port Townsend, Wa 98368 Jefferson Healthcare Ms Dana Michelsen 834 Sheridan St Port Townsend, WA 98368 (360) 38s-2200 dmichaelsen@jgh.org City of Port Townsend Jan Hopfenbeck 181 Quincy St STE 301 Port Townsend, WA 98368 (360) 37e-5087 jhopfenbeck@ci,port-townsend,wa.us N/A cRs# 9467 Jefferson Healthcare Chapter 246-320 WAC Hospitals Fast Track Urgent Care Project Matthew Campbell matthew. campbell@doh,wa. gov Jefferson Healthcare Mr Vic Dirkson 834 Sheridan St Port Townsend, WA 98368 (360) 38s-2200 Project location Local Permit #: Facility Contact: ! DOH Child Birth Center Licensing n DOH Office of Accommodations & Res. Care Survey Fire Alarm Contractor: Other:N/A DOH Office of Health Care SurveyDSHS, , Div. Of Alcohol and Substance AbuseDSHS, , Aging & Adult Services Administration Page 1 of7 Plan Review Comments for Project #9467 Jefferson Healthcare - Fast r-. ^tlUrgent Care Project Jan Hopfenbeck Page 1 of I From: Campbell, Matthew (DOH) [Matthew.Campbell@DOH.WA.GOVI Sent: Tuesday, August 28,2007 9:21 AM To: Jan Hopfenbeck; Rick Taylor Gc: Smoot, Janet (DOH); Williams, John (DOH) Subject: Jefferson Healthcare - Fast Track Urgent Care Project Attachments: 9467.doc Find below email as sent from our office for the above mentioned project. Bob, is the architect and point of contact for the project. Bob, This project is not approved due to the following missing information 1. An lnfection Controlform has not been provided. 2. Some functional program questions need answering 3. Oxygen and Vacuum outlets need to be provided to each exam room in the Fast Track Emergency Department. I have attached the project comment form for your use, Please don't hesitate to contact me with any questions. <<9467.doc>> Thank you, contact Janet Smoot @ janet.smoot@doh.wa.gov, or myself should you have any questions. Matthew Campbell Construction Review Services Washington State Department of Health Voice :360.236.2944 Fax: 360.236.2901 Public Health - Always working for a Safer and Healthier Washington Yhis message m*y be mnfidenfial. ff y*u received if by misf*ke, ple*se notify flte sender and delete f he n*ss*ge. All nessaqes fp axl fram rhe heperflftet1t af /"{ea/th may be dttclosed to tha publtt. 917/2007 Receipt Number iffiSi BLD07-170 BLD07-170 BLD07-170 BLD07-170 BLDOT-I70 948319202 948319202 948319202 948319202 948319202 $1,082.74 $33.32 $4.50 $1,665.75 $10.00 Total $832.74 $33.32 $4.50 $1,665.75 $10.00 Plan Review Fee Technology Fee for Building Permit State Building Code Gouncil Fee Building Perm it Fee Record Retention Fee for Building P $0.00 $0-00 $0.00 $0.00 $0.00 $2,546.31 07-07't5 CHFCK 0811412007 Plan Review Fee 63302 Total $250.00 BLD07-170 $ 2,546.31 Ez,iao.sr genprntrreceipts l%ge 1 of 1 City of Port Townsend Deve lopme nt Se rvices Department 250 Madison Street, Suite 3, Port Townsend, WA 98368 (360)37e-50e5 lnvoice #' tll - lnvoice pu1", o6-o-ro7 l,,f, \\, JEFFERSON CO PUBL HOSP DIST #2 834 SHERIDAN ST PORT TOWNSEND WA 98368-2443 Application No BLD07-'170 Project: ApplicationType C,omrnercialMiscellaneous Parcel # 948319202 Subdivision: ESENBES ADDIION Site Address: 834 SHERIDAN Description Building Fern$t Fee Flan Review Fee State Building Code Council Fee Technology Fee for Building Permit Record Retention Fee for Building Permit Blocldlot Fee Anlount $1665.75 $1082.74 $4.50 $33.32 $10.00 l%idlcredii $0.00 $250.00 $0.00 $0.00 $o.oo Balance Due $1665.75 $832.74 $4.50 $33.32 $10.00 $2796.31 $250.00 sisao.stl Total Fee ArDunt: Tolal t%kl/Credits: Balance Due: Payment due within 30 days ,r* Y Fbge 1 Letter of Transmittal August 27,2007 "i ./,"' ffiiffi;;iff; Construction Review Services 310 Israel Road SE Tumwater, WA 98501 PO Box 47852 Olympi4 Washingtorr 98504-7 852 www.doh.wa.gov/crs tel.360-236-2944 fax.360-236-2901 Project Info: Architect / Engineer: cRS# 9467 Jefferson Healthcare Chapter 246-320 WAC Hospitals Fast Track Urgent Care Project Project location: Local Permit #: Facility Contact: Building Official: 834 Sheridan St Port Townsend, Wa 98368 Jefferson Healthcare Ms Dana Michelsen 834 Sheridan St Port Townsend, WA 98368 (360) 385-2200 dmichaelsen@jgh.org City of Port Townsend Jan Hopfenbeck XXXXXXXX XXXXXXXXXXXX (360) 379-s087 jhopfenbeck@ci.port-townsend.wa.us N/A Key People: Assigned DOH Reviewer: Facility Administrator: Jefferson Healthcare Mr Vic Dirkson 834 Sheridan St Port Townsend, WA 98368 (360) 38s-2200 Sprinkler / Contractor: Rice Fergus Miller Mr Bob Rhees 262 4th St Bremerton, WA 98337 (360)271-s287 bmiller-rhees@rfarch.com N/A Other:N/A Copies To: X Local Building Official: X Washington State Patrol, Fire Protection Bureau X Architect / Engineer: Rice Fergus Miller!n Sub-Contractor: N/A Sub-Contractor: N/A ! other: X cRS File n!nntrXn Fire Alarm Contractor: Other:N/A DOH Child Birth Center Licensing DOH Office of Accommodations & Res. Care Survey DOH Office of Health Care Survey DSHS, , Div. Of Alcohol and Substance Abuse DSHS, , Aging & Adult Services Administration L&I, Bill Echroth, Electrical Section L&\ , Factory Assembled Structures Page I of6 Plan Review Comments forProject #9467 Jefferson Healthcare Chapter 246-320 WAC Hospitals Fast Track Urgent Care Project Memo: NOT APPROVED. REVISE AND RESUBMIT - This project is not approved and is not yet authorized for use by the Licensing Agency. Provide written responses to our review, using our numbering system, for those items checked as not approved. To help expedite our review include a transmittal with all submissions clearly identiffing all documents with your project name and CRS project number. Include two copies of revised plans or sheets, in the same format/size as the original submission, incorporating your corrections. Any response that does not address ALL the review comments and provide the required information will be considered incomplete and returned without review. All documents submitted will be retained in our office until all the construction documents have been received, reviewed, and accepted. When the project is approved a complete package of accepted documents will be stamped and signed by the department. One copy will be returned to the facility administoator and one retained for our records. Please visit the link to Project Status on our web site at www.doh.wa.gov/crs. Page2 of 6 Plan Review Comments forProject # 9467 )) F Data Certificate: 000033 X Yes nNo Estimated Date of Occupancy:March 10,2008 Jefferson HealthcareFacility Name: Site Address: DOH Facility ID: Critical Access Facility:834 Sheridan St Port Townsend, Wa 98368 0H F F Fl U h FlI Occupancy Group: B Construction Type: 2-B Applicable Code Number of Beds: Current:Added Removed Total: Automatic Fire Sprinkler System: I Yes n No Type Automatic Fire Alarm System: I Yes n No Compartmentation req' d:XYes nNo Smoke Control System Provided: I Ves nNo Special Delayed Egress Control: I Ves XNo Location Certificate of Need Required: n Yes XNo CON Approval Granted: CON Number : n Yes nNo rnd><Flav '4A )-'{ FEItiFz=rdi dz Hri Number of units: Private occupancy: Based on size of rooms used for sleeping Residents Based on size of common rooms Residents Maximum allowable licensable beds: Two person occupancy: Qualifies for Assisted Living Funding Program n Yes []No Number of qualiffing units: 0 trl Fr z 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 of6 Plan Review Comments for Project # 9467 Jefferson Healthcare Chapter 246-320 WAC Hospitals Fast Track Urgent Care Project Plan Review Comments J €noF>9EE.FEA-jo o: o(-) <r ,EI 2 Provide a completed copy of the facility's Infection Control Risk Assessment (ICRA) for this project. This assessment would identiff risks and describe provisions for infection control and safety of the facility's occupants during any renovation or new construction projects. Each ICRA must be individually tailored to fit each phase of the project. The designer must incorporate the requirements of the ICRA into theconstruction*'T"";;ilili"#:l:,'l':ffi:'I:']:;:il::iJ::'L, : ffi;essureoutlets, : ffi:::;;:'*u Assessments that are incomplete or do not address the specific project will not be approved. Construction Review Staff is available to meet with the facility, design team and contractor to develop a plan. Contact your assigned DOH reviewer for more information. WAC 246-320-405(1) and WAC 246-320-505(2)(a)(iD El The functional program describes sharing support facilities with the emergency room. Describe how medications and soiled functions will be utilized for the new Fast Track area when sharing those support areas with the Emergency Department which is across the corridor. It appears the intention is to have staff cross back and forth through an existing waiting area. wAC 246-320-s0s(2)(a) E Provide a description in the functional program to describe how services will be provided if Alternate A-2 is completed. The drawings show the Trauma room and Soiled Utility room being closed during the renovation. wAC 246-320-s0s(2)(a) Page 4 of6 Plan Review Comments for Project # 9467 o eoE oz o 9>tso OQO< Provide Exam 65-M289 with either negative or positive pressurization. The definition of pressurizationis 70 CFM per WAC 246-320-010(a or b). (Sheet M202) wAc 246-320-40s(e)(c)(ii) 4 Provide Tamper-proof receptacles Waiting#65-M287, Exams #65-M288, #65-M289 & 65-M29r. (Sheet E201) WAC 246-320-525, Table 525-5 E Provide 1 oxygen and I vacuum outlet to each Exam room in the fast track unit. V/AC 246-320-525, Table 525-2 (Emergency exam rooms) Note: This building is un-sprinklered Note: Portable fire extinguishers shall be provided in every busihess occupany in accordance with NFPA l0l - 9.7 .4.1. It is noted a Fire Extinguisher cabinet is located in the main circulation area of the Fast Track Unit as this area does not have fire sprinklers. NFPA 3 8.3.5 Compliance with the coftrrtents above provided by the Departftient of Health, Construction Review Services, are necessary for this facility to meet the requirements ofthe applicable licensing regulationsfound in the llashington State Administrative Code and associated references, These comments do not relieve the facility from the responsibility to meet the requirements of any other applicable federal, state or local regulations. In the event of conflicts between other jurisdictions and these written comments, the most stringent shall apply. 5 Page 5 of6 Plan Review Comments forProject # 9467 2 2 3 6 3 & L S O J \ I z o a 915 1 9 1 3 4 5 4 5 5 4 gTH ST H - 1 0 3 7 in&u g T H S T 1 8 8 8 1 1 6 3 2 1 0 2 2 7 2 3 6 a f i 2 1 2 3 4 5 5 4 8TH ST - o q ' \ " T a \ } V C (-)'U 8 3 4 O S P I l " * i { o ' - 1 2 7 2 2 0 W a t e r 4 2 2 0 8 3 W a s t e W a t e r S t o m W a t e r s 1 i n c h e q u u . b 1 0 0 f e e t p t r ! l u i l q c i r p m v r d c d , r r : E " s r s , " " d t h , 1 1 f r : J t s , " b a s ! . l h r , l i * o i l , o r ' f o t n s c n d r : d i s e n r p ) o , r t a d a m r ? : r . i h r i . a 1 i s a - y t i c a . c d a c J . t t h e , : i i ' r n : r r i r , . : , i ' i l t : ( , 1 i : : r h i s , n . r p . F i c l , . l . . r n t i . : a r i r r , , i t l ' t z c c : z r : c f r i l m z 1 b f o m a t i o n i . d r c s r i e , . , t c i ! 5 , i . a i i ) r ! i c ' . l - s c ! ( ] c a r { s i I . ( ] f t o i r : : n ' i : q n i c r r r r ; , L i , : : e q > ! c , r r c s f u ' r n z r r l ; a l f i r r I . : s t C o s u s < : r ' . r , r c , : r i n v D , a t a t a B l j o t . 1 8 S RCP 0 * A ^ 1 G 2 4 Parcel Details Parcel Number I 9483 r920 Parcel Number: 9483L9202 Owner Mailing Address: JEFFERSON CO PUBL HOSP DIST #2 834 SHERIDAN ST PORT TOWNSEN D WA983682443 Site Address: Page I of2 Pg'iltt*f Fs"iendly_ Sub Division: EISENBEIS ADDITION As$sssor'$ Lcrnd Use Csds: 9700 - EXEMPT Property Description: ETSENBETS ADDTTTON I BLK 192, I LOTS 3 THRU 6(LS N10' OF 3/6) | rNC PTN VAC gTH STABT LT 4 & 5 | SUBJ/EASE Click on photo for larger image, Section: 10 Qtr Section: SEI/4 Township: 30N Range: 1W x No Ph0i0 Availabl* School District: Port Townsend (50) Firc Dist: Port Townsend (B) Tax Status: County Tax Code: 100 Planning area: Port Townsend (1) x No ?nd Ph0i{) Avail*ble Jsfferson {ount SEARCH No Permit Data Available No Assessor Data Available l-""-. Iax=4lv,Salellnls Jgftarron (or*aty '.,t:.;,'.:.. . i H&brs I e*{.1$YY ENr* | nfrpARTMfrf{T$ I $HAKShr $est viewed with Micrassft lnternet fixplorer 6,0 or later http : i/www. co j efferson.wa.us/assessors/parcel/parceldetail. asp 81t712007 $LD i7'f,o Jefferson Healthcare: Fast Track Urgent Gare project ADDENDUM #1 April4, 2008 TO ALL BIDDERS The original drawings and specifications for the project noted above are amended by this Addendum. Receipt of this addendum shall be acknowledged by inserting its number in the space provided on the bid form. DRAWINGS 1.A-0: REVISE the Owner's contact information to read as follows: Dana Michelsen, Phone: (360) 385-2200 extension 2066. Fax: (360) 385- 1421. 41-1. DELETE detail 1. Roof Curb. There are no new penetrations through the roof included in the scope of the project. A-2: Demolition Plan. ADD note in rooms TOIL 65-M292 and SHWR 65- M308 to read, "Demo ceiling and lighting". Plast'er ceiling was demolished as part of asbestos abatement by the Owner. Remaining light fixtures, mechanical and electrical items, suspensions system, etc. needs to be removed. Edges of ceiling need to be trimmed and prepped for installation of new ceiling as scheduled. A-2: Demolition Plan. DELETE note that reads, "Cut roof penetrations for new exhaust fans (x2)." There are no new roof penetrations in the project. A-2 Partial Main Floor Plan. DELETE note that reads, "Provide roof penetration and equipment curb for exhaust fan - see detail 1/A101 typical of (2) locations." A-2. Partial Main Floor Plan. ADD notes at locations shown in attached sketch AD-1, dated April 4, 2008. Note #1. Existing veneer plaster/wire stud partitions are to be tEG V to the roof deck above with 3-5/8"metal stud and 5/8" type rE il each side similar. to construction of Type 3 partitions on sheet ction is to be consistent with requirements for t hour fire re taped and all penetrations sealed). Provide metal stud l,lAY -? 20cii o "kickers" at 4'-0" on center max (alternate sides)for stability of OF PORT lOV,JNSEND 2 3 4 5. 6 cllY DSD ly. See attached detail4lAD-2 Addendum #'1 Jefferson Healthcare: Fast Track Urgent Care project April4,2008 Page 2 of 3 Note#2. Provide t hour rated metal stud and gwb infill above the existing hollow metal door frame. contractor's option to use shaft wall construction ("c-h" studs) to avoid removing ceiling in the hallway. Note#3. Extend the Owner built metal stud wall to roof deck above. Construction is to be similar to type 3 partition on sheet A-4 and consistent with sound rated construction. Provide metal stud diagonal "kickers" at 4'-0" on center max (alternate sides) for stability of the wall assembly. Provide 2-layers 5/8" type 'x'GWB on the Exam room side of the wall, full height. See attached detait SIAD-2. Note#4. Existing veneer plaster/wire stud partitions are to be stabilized with metal stud diagonal "kickers" at 4'-0" on center (alternate sides). A-3. Partial Reflected ceiling Plan. ADD suspended MRGWB ceilings to rooms TOIL 65-M292 and SHWR 65-M308. Coordinate tight fixtures and mechanical grill locations included in this addendum. A-3. Room Finish Schedule. CHANGE ceiting in Waiting 65-M285 from 'EXIST" to new "ACT" tiles in existing grid. A-3. Room Finish Schedule. CHANGE ceiling in TO|L 65-M292 from "EXIST'to "MRGWB". Change all wall and ceiling paint from "p/1B" to "Pl1C". See detail 6/AD-3 for typical construction of GWB suspension system. 10 A-3. Room Finish Schedule. ADD entry for room SHWR 6S-M308. Wall and floors are existing to remain. Ceiling is to be .MRGWB'. paint for all walls and floors is to be "Pl1C". See detail 6/AD-3 for typical construction of GWB suspension system. 11. M002. ADD a toilet exhaust grille to the GRD schedule. See ADM-01 12. M002. DELETE the EF-1 exhaust fan. See ADM-01 13 M201. REVISE general demo within the construction area except for the existing exhaust system. See ADM-02. 14 M202. DELETE the exhaust fans. ADD the exhaust grilles in the toilet rooms, connect to the existing exhaust system. See ADM-03. 7 8 I 15. P202. ADD note #3. See ADP-O1 Addendum #1 Jefferson Healthcare: Fast Track Urgent Care project April4, 2008 Page 3 of 3 16. T7 18. 19. E201. DELETE scope of work associated with installation of new exhaust fan in Staff Room 65-M307. See ADE-02. E201. DELETE scope of work associated with installation of new exhaust fan in Toilet 65-M294. See ADE-02. E301. REPLACE 2' x2'fixture in Toilet 65-M294 with a single down light. Switching and circuiting requirements to remain as previously indicated. E301. ADD new down light over the shower in Toilet 65-M292. ADD new down light over the water closet in Toilet 65-M292. provide individual switches for the new fixtures. switches shall be co-located in the existing single gang box. Fixtures shall be circuited to existing lighting branch circuit serving the space. ATTACHMENTS Pre-Bid Walk Thru attendees list, dated April 4, 2OOg,1page. Approved Bidders list, dated April4, 2008, 1 page. Architectural sketches AD-1 - AD-3, dated April 4, 2008, 3 pages. Mechanicalsketches ADM-01 - ADM-03 dated April4, 2008, 3 pages. Plumbing sketches ADP-01 dated April 4, 2008, 1 page. Electrical sketches ADE-01 - ADE-02 dated April 4, 2008, 2 page. END OF ADDENDUM #1 BMR\Projects\Jefferson\Urgent Care\8-Bidding and Negotiation\Addendum #1.docx 1 2 3 4 5 6 , 1 1 : t I : i I a - l € , r r / * r r g o p . . , t i " , C f ( € L - r r , Q r y h ' v i : r t l . t l n / i r ' r " A $ 1 ] r ' t y i - I ? f l $ ' p s - t n ? i l , j : j r . , / ! . i , , ' l " , . i : . i , . , ' . , . : ! . ! . . ' : \ . 1 ' . . ' i i - ] l | | . ' / . i " l ; 1 / { : < ) . : ' . , i ' : . . ' , / ' I ' , . , { " , i i Jefferson Healthcare: Fast Track Urgent Care project ADDENDUM #1 April4, 2008 Approved Bidders. Fischer General Gontracting, Inc. Dan Fischer P.O. Box 661 Poulsbo, WA 98370 Phone: 360-697-5402 Fax: 360-779-4373 e-mail : dan.fgci@fischergeneral.com Hoch Construction Rick Hoch 4201 Tumwater Truck Rte Port Angeles, WA 98363 Phone: 360-452-5381 Fax: 360-452-5382 e-mail: hoch@olympus.net I _ * ","-J. *.trbr.w tfr't S-. * +"9h.,-. &;P'*', -.4;,,* .;*. fr3i?'" .*..-'m:: Pnalvl6€ EOCF FEr&rR4rr$i 4s ea,!F?6$ cl,g reF !F{4,9r rAt . 6E€i)€ral tal.t lYptcA[ 6 (tJ iftit,lll4s _t 'i; fkt{ Fnrc4figFdlFrtlcielr at t c'ffigD F.:{i9r AJit,{c€t N rlLsir4t: CFAs FEn$yAL $,6! tl€ FA'O{ Aqg uia$,6 Fca ao Locrf&.t ,tsNlcgi" trupbet{6 l,t{l,6Frd -l!xrl&6l€lal cer{,8€& canr,Ef; " sEA' 3iltp:ftn Rl(R AFG,I$gxlgte5 glr0l Exr8l tgr; s{_i,Kra Tt r81$ti i'f St' rlg tm^165.!it0 I I crFtttr r- U UJ-! t & tlj g. 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CUT, IRIiJF & SCRrW MAX s StNss t*[tl pAgilT'sii EHSNFJS PARTNSb' Ix is Stud Fcrtition illosu ne txrsilNG pAR]ill0r{ ht0tl: A$$[M*LY MUS? FR0\flff rOs A 5 LB/sr IJH PARtn0F' L0AilNG NIW RUNNTR IRACS SACX TO BAf;K UTH rxtsll|.}$ RtiNhttR TRACK ?* /1 I tr ?rt* r t JN M etcl b*t ) htFtv4, q d 7 ' * l t g l r U t f : 6 O - ; l = * f , I i l s 3 g s $ t D s l I S & S U A ; X ; I d A t * 8 1 $ " 3 0 " e t @ l l 3 N N ! r | $ S I \ f l 8 U r J J , ? / L ] S N N V H C 0 3 1 1 0 u 0 " 1 C I s , e / l - l d n c $ N H s m l $ t f r [ U l g N V , t { t + 'l Fhck + Krtz lnc. 600 University St. Suite 500 Seottle, WA 98101-4132 Tel. (206) 342-9900 Fox (206) 342-seo1 lwsr SKETCH DRAWING A I'ISP eoup cmpotry GRILLI, REGISTTR & DIFFUSER SCHTDULI FACEITEM SIZE NECK SIZE INCHES DUCT SIZE INCHES MAX AIRFLOW CFM NC ESP THROW Fr. DESCRIPTION NOTES MANUFACTURER & MODEL NO. 1 NOTES:1 COORDINA]E LOCATIONS WITH ARCHITECTUML CEILING PI-AN FOR LOCATIONS AND CEIUNG ryPE.2 THROW VALUES ARE BASID ON ISOTHERMAL AIR AND VELOCITIES OF 50 AND 15O FPM.3 NC VALUES ARE BASED 0N R00M AflENUAT|ON 0F t0dB RE:12 - 12 WATTS.4 UNLESS INDICATED OTHERWISE ON DRAWNGS.5 WHERT A 90 DEGREE BI.ANK_OFF IS USED INCREASE THE NECK SIZE BY ONE SIZE. EtEMtl& URGI]JIGRD.ir FAN SCHEDULE MOTOR ryPE CFM STATIC PRESSURE SIZE RPM BHP HP REI/ARKS PROJECT JEFFERSON HEALTH CARE FAST TRACK URGENT CARE REVISION ADDENDUM #1 PROJECT NO. w06-31 460 DATE: lL 4, 2009 DWG. NO. M002 SCALE: NONE SKETCH DRAWING NO. ADM_01 ) Flack + Kurtz hc. 600 University St. Suiie 500 Seottle, WA 98101-4132 Tel. (206) 342-9900 Fox (206) 342-es01 b ) SKETCH DRAWING WSP ^ rrp ooup corpony 4 4 4 5 1 16 3 45 6 1 3 7 8 ti;..-'lixt f--1 L J EXISTING ROOM EXHAUST BRANCH DUCTWORK TO REMAIN. REMOVE EXISTING EXHAUSI GRILLE AND CAP. EXISTING ROOM EXHAUST BRANCH DUCTWORK TO BE REMOVED. REMOVE BACK TO MAIN DUCT CAP AND SEAL, CAP AND SEAL EXISTING DUCT WALL PENETRATION. DEMO EXISTING ROOM EXHAUST DUCT. UP TO EXISTING EXHAUST SHEET NOTES DEMO ALL ABANDONED EQUIPMENT ABOVE CEILING INCLUDING. DEMO ABANDONED PIPING. DEMO POWER BACK TO SERVING PANEL. CUT CAP AND SEAL. I L *trl).i.-t;a*:ii l.':' !......:...::.4?, :: i NUMBERED NOTES REMOVE EXISTING SUPPLY AND RETURN DUCTWORK. REMOVE EXISTING CAP ON ABANDONED RETURN AIR DUCT. *&xni;"i* 1;;;:-.j PROJECT JEFFERSON HEALTH CARE FAST TRACK URGENT CARE REVISION ADDENDUM #1 PROJECT NO. w06-31 460 DATE: APRTL 4, 2008 DWG. NO. M201 SCALE: 1 /8"=1'-0" SKETCH DRAWING NO, ADM-02 ) Flack + Kurtz hc. 600 University St. Suite 500 Seottle, WA 98101-4132 I:l [;33i ii3:333i ]wsn ^$pooupc.i,pov ) SKETCH DRAWING Lqi NUMBERTD NOTES s 4Wffi f --- t ------- l 1 /- rr *l/l*- | l' r'4 "1")t NEW 12X12,, RETURN AIR DUCT, ATTACH IO EXISTING 12X12'' RETURN DUCT. (--,\"- CONICAL SPIN-IN BRANCH CONNECTION TYPICAL ZONE THERMOSTAT CONTROLS EXISTING HOT WATER REHEAT c0lL Ht--*'- 1'"*Y;t' sT*ffie 90c TWO WAY BLOW i t ttlI !-l I :t-. REMOVE EXISTING SKYLIGHT REPLACE WITH TEMPORARY SAFING WITH TWO 10,, DIAMETER SLEEVES FOR CONNECTION TO HEPA NEGATIVE AIR UNITS (rnovtoro BY HosptTAL) ' ,/.,/ / . '.,/ t' i NOT USED **-r'.*x* vfffi t" j PROVIDE 6,,X6'' EXHAUST TO EXISTING EXHAUST MAIN. PROVIDE BALANCING DAMPER CLOSE TO MAIN. PROJECT JEFFERSON HEALTH CARE FAST TRACK URGENT CARE REVISION ADDENDUM #1 PROJECT NO. vvo6-51 460 TE: RIL 4, 2008 DWG. NO. M2A2 SCALE: 1 / 4"=1'-0" SKETCH DRAWING NO. ADM_03 .-.\ ) Fhck + Kfiz lnc. 600 University St. Suite 500 Seottle, WA 98101-4132 Ter. (206) J42-9900 rox (zoo) J42-s901 ) SKETCH DRAWING 1} wsn A YJsp en' cmponv ANUMBERED NOTES 1/2',02 & l"M.V. DOWN TO WALL OUTLET. REFER TO ARCH. DRAWINGS FOR LOCATIONS AT PIPING WHERE INSULATION HAS BEEN ABATED, REPLACE WITH NEW INSULATION (F|BERGI,ASS wlTH ALL sERVtcE JAcKFI) THICKNESS TO MATCH EXISTING AND PVC COVERS ON AS REOUIRED ON nnNGS (90's, 45's, STRAINERS, ETC.) o INSTALL 60' A.F.F PROJECT JEFFERSON HEALTH CARE FAST TRACK URGENT CARE REVISION ADDENDUM #1 PROJECT NO. w06-31 460 DATE: APRIL 4, 2OO8 DWG. NO. P202 SCALE NONE SKETCH DRAWING NO. ADP-01 ) Flack + Kurtz lnc. 600 University St. Suite 500 Seottle, WA 98101-41J2 Tel. (206) Fox (206)f wSe ^lvspGrdpcmpony 342-9900 342-9901 SKETCH DRAWING NUMBERTD NOTES EXTEND TO NEAREST 12OV LIFESAFETY CIRCUIT TO SERVE EGRESS LIGHTING AND EXIT SIGNAGE. EXTEND TO ELECTRIC FAN CONTROLLED BY LIGHT SWITCH SEE SHEET E201. L............1- .---l:- - i i .,.,,...'.'.'.'''...r il REUST EXISTING CIRCUIT TO SERVE NTW LIGHT FIXTURES PROVIDE NEW LIGHT SWITCHES FOR NEW TOILET ROOM AND SHOWER FIXTURES. M0UNT SWITCHES lN EXISTING SINGLE GANG BOX. FISH WIRES DOWN EXISTING CONDUIT TO AVOID DISTURBANCE OF EXISTING TILE WALL. PROVIDE NEW 6'' LENSED DOWN LIGHT RATED FOR WTT LOCATIONS. (ronrrolro srRtES 0R AppRovED rouAL). {'ItJr\ a ) 5j i' ;rt";\,:-t F1 T 0 PROJECT JEFFERSON HTALTH CARE FAST TRACK URGENT CARE REVISION ADDENDUM #1 PROJECT NO. w06-31 460 DATE: lL 4, 2009 DWG. NO. E-30 1 SCALE: 1 / 4" =1'-A" SKETCH DRAWING NO. ADt-01 Flack + Kurtz ln. , 600 University St. Suite 500 Seottle, V/A 98101-4132 SKETCH DRAWING Tel. Fox (206) (206)I wsn AffipcnpmDo,y J42-9900 542-9901 $TATT STATil T \$gtiif 1 7 G ER-.ft$ ! t ft"r * HSRM ' t- f-* I L* PROVIDE ELECTRI L CONNECTION TO X-RAY VIEWING STATION. NOT USED. ll g rx! $ \1fi fi- 'r.aa. E $ s*'lr $ \.dtl $-$- $ PROJECT JEFFERSON HTALTH CARE FAST TRACK URGENT CARE REVISION ADDENDUM #1 PROJECT NO. w06-31 460 TE; RIL 4, 2008ff DWG. NO. E-201 SCALE 1 / 4"=1'-0" SKETCH DRAWING NO. ADE_02 City of Port Townsend Development Services Department 250 Madison Street Suite 3, Port Townsend, WA 98368 (360) 379-s09s FAX (360) 344-4619 March 24,2008 Ms. Dana Michelsen Jefferson Healthcare 834 Sheridan Street Port Townsend, WA 98368 SUBJECT: Request for extension of BLD07-170 Dear Ms. Michelsen, We received your e-mailed request to extend your permitfor 120 days. The permit was originally approved October 1,2007. Your permit extension is approved. The new expiration date is 120 days from the date of this letter. S Leonard Development Services Department 250 Madison Street, Suite 3 Port Townsend, WA 98368 (360) 344-4601 Page 1 of 1 Pat lolavera From: Michelsen, Dana [DMICHELSEN@JGH.ORG] Sent: Thursday, March 06, 2008 2:20 PM To: Pat lolavera Subject: RE: Request extension for project # 07-170 Address it to Dana Michelsen Jefferson Healthcare 834 Sheridan Street Port Townsend, Wa 98368 |)t ry:3t lt L I From : Pat lolavera [mai lto : piolavera@ciVofpt. us] Sent: Thursday, March 06, 2008 2:13 PM To: Michelsen, Dana Subject: RE: Request extension for project # 07-I70 Thanks, could you make it really easy for me and send me your mailing address for the response Thanks From : Michelsen, Dana Imai lto: DMICHELSEN @JGH.ORG] Sent: Thursday, March 06,2008 2:13 PM To: Pat Iolavera Subject: RE: Request extension for project # 07-t70 Woops sorry, it's a BLD Fro m : Pat Io lavera [m ai lto : piolavera@cityofpt. us] Sent: Thursday, March 06, 2008 2:11 PM To: Michelsen, Dana Subject: RE: Request extension for project # 07-L70 Dana, ls that a BLD or LUP? Pat From: Michelsen, Dana [mailto:DMICHELSEN@JGH.ORG] Sent: Thursday, March 06,2008 2:09 PM To: Pat lolavera; Leonard Yarberry Subject: Request extension for project # O7-L70 Dear Patricia and Leonard, We just received permission from the hospital commission to go forward with this project. lt was approved by the city on October 1,2007 for construction. The project name is Fast Track Urgent Care Project. We are requesting a 120 day extension of the project with a bid date of April 7, 2008 and a completion date in July of 2008. I can be reached at 385-2200 ext. 2066. Thanks you for your consideration of this matter. Sincerely, Dana Michelsen 311312008 Page I ofl Pat lolavera From: Michelsen, Dana [DMICHELSEN@JGH.ORG] Sent: Thursday, March 06, 2008 2:13 PM To: Pat lolavera Subject: RE: Request extension for project # 07-170 Woops sorry, it's a BLD From : Pat Iolavera [ma i lto : piolavera@cityofpt. us] Sent: Thursday, March 06, 2008 2:11 PM To: Michelsen, Dana Subject: RE: Request extension for project # 07-L70 Dana, ls that a BLD or LUP? Pat From: Michelsen, Dana [mailto:DMICHELSEN@JGH.ORG] Sent: Thursday, March 06, 2008 2:09 PM To: Pat Iolavera; Leonard Yarberry Subject: Request extension for project # 07-L70 Dear Patricia and Leonard, We just received permission from the hospital commission to go fonruard with this project. lt was approved by the city on October 1,2007 for construction. The project name is Fast Track Urgent Care Project. We are requesting a 120 day extension of the project with a bid date of April 7 ,2008 and a completion date in July of 2008. I can be reached at385-2200 ext. 2066. Thanks you for your consideration of this matter. Sincerely, Dana Michelsen 3113t2008 Pat lolavera Page 1 of1 From: Michelsen, Dana [DMICHELSEN@JGH,ORG] Sent: Thursday, March 06, 2008 2:09 PM To: Pat lolavera; Leonard Yarberry Subject: Request extension for project # 07-170 Dear Patricia and Leonard, We just received permission from the hospital commission to go forward with this project. lt was approved by the city on October 1,2007 for construction. The project name is Fast Track Urgent Care Project. We are requesting a 120 day extension of the project with a bid date of April 7,2008 and a completion date in July of 2008. I can be reached at 385-2200 ext. 2066. Thanks you for your consideration of this matter. Sincerely, Dana Michelsen 3113/2008