This project was approached in multiple phases to accommodate an addition and renovation to the existing hospital. The new emergency area addition was added over what would become the emergency entrance. A new penthouse was added and included ventilation/AHUs and heat exchangers served from the existing boiler plant. New plumbing, process, and HVAC distribution was included for the addition of the emergency area. Phase 2 of the project included renovations to labs, including plumbing and HVAC.