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
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)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
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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{-+
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Construction Review Services Ftme Page Page 1 of2
/ fqni[i*r nnd Ssrs*nn$ tringnsiw ^ & j
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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.
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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.
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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
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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
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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
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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-
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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.
#
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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.
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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.
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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
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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
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JUL - 3 2t)OB
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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.
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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
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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**
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Bob Miller-Rhees
Architect, LEED@ AP
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CITY OF PORT TOWNSEND
DSD
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ExpirationDate104/95/ il
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Date
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Date Subrilitrsa losrfl a/200?
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i0/05/2007
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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
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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
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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
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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
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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
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=>=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
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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
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)-'{ 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
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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
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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
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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
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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