This project was a combination of a new 9-story structure and complete renovations of two levels of an existing emergency department, with multiple points of interface between new construction and existing structures still in use by the medical facility. Separate crews worked on the existing tie-in areas at all hours, while a large crew was working simultaneously at multiple levels of the new building, interiors and exteriors. The project required over 2000 RFI’s, dictating diligent organization and communication between the project leaders, installers, and the general contractor.