Design and construction of a 216,380 SF post tensioned, cast-in-place concrete parking structure on an occupied hospital campus. The new six-level, 604-stall facility was built simultaneously with the new adjacent Medical Office Building (MOB), which was constructed by another general contractor (GC). Careful coordination with the other GC on concrete pour schedules, traffic, pedestrian access/right-of-ways, and material deliveries was vital. We self-performed the formwork for faster project delivery with increased control over quality and safety. The parking structure is designed to Calgreen Tier 1 standards. Sustainability features include EV charging stations with provisions for additional future stations, setup for a future solar panel carport installation, and large vine screens. The facility was designed to maximize formwork re-use.