Get Il Dph 443086 2017-2025

The IL DPH 443086 form serves as a Project Submission Form for hospitals, enabling facilities to submit proposals for construction or renovation projects. This guide provides a clear, step-by-step process to complete the form online, ensuring that all necessary components are filled accurately and comprehensively.

Follow the steps to complete the IL DPH 443086 form online.

1. Click the 'Get Form' button to access the IL DPH 443086 online. This action will open the form in your digital workspace for editing.
2. Begin by entering the facility identifying information. Complete all required fields, including the facility name, street address, city, state, and ZIP code, as all sections must be completed for the form to be valid.
3. Subtract the project identifying information. Fill in the IDPH number, project name, type of project (indicating whether it is new, a replacement facility, renovation, or addition), and type of submission (selecting from design development drawings or construction/working drawings).
4. Input the total gross square footage of the project area and the number of beds. Specify the present and proposed numbers for various bed types (e.g., acute mental illness, ICU, long term care) and calculate any changes.
5. Provide the certificate of need details if applicable. Attach a copy of the approved certificate, and if this is a phased occupancy project, add a schedule detailing the occupancy for each phase.
6. Outline the drawing submission requirements in accordance with the Illinois Hospital Licensing Requirements. Specify that one set of signed and sealed drawings is to be submitted for review.
7. Detail the estimated project cost in terms of site preparation, demolition, construction contracts, and any change orders. Calculate the subtotal of these costs and include any anticipated costs for fixed capital equipment.
8. Determine the plan review fee based on the estimated project cost, referring to the outlined fee structure. Complete the relevant calculations to finalize the fee to be submitted with the form.
9. Complete the code analysis information for both existing and new buildings or additions, circling the relevant construction types and providing additional construction details as necessary.
10. Fill in the contact information section, ensuring all necessary details for facility representatives, architects, contractors, and relevant firms are provided.
11. Create a functional program narrative to describe the project purpose, space requirements, and services necessary for operation. Attach additional sheets if necessary.
12. Finish by saving all changes made to the form. Options will generally include downloading, printing, or sharing the completed form as needed.

Begin filling out your IL DPH 443086 form online today to ensure a smooth project submission process.