Design and construction of a major addition to an operational hospital facility. A central plant was built to provide utility support to the new addition. This included the installation of a new 750KW emergency generator system and its associated ATS’s. A new steam plant powered by a sequence of steam boilers, new hot water boilers, new medical gas system, and all associated water treatment equipment, piping, and pumps was also provided. Seismic and snow load upgrades were performed at all points of interface between the existing buildings adjoining the new addition. 6,000 square feet of the existing hospital was also renovated. This included an MRI suite, imaging center, outpatient surgery center, kitchen/cafe, shear walls, and lobby.