Based on the California Building Code (CBC) and IBC 2021, a Type I-A high-rise healthcare occupancy over 75 feet requires:

Automatic Sprinkler Systems per IBC §903.2.1.1 1:

• Throughout all floors, including mechanical rooms and elevator shafts
• NFPA 13 compliant design required

High-Rise Provisions per IBC §403.3 2:

• Secondary water supply required
• Fire pump with emergency power backup
• Standpipe system per IBC §905.3.1 3

California Amendments per CBC §903.2.1.1.1 4:

• More stringent than base IBC: sprinklers required in all occupancies over 5,000 sq ft
• Seismic bracing per OSHPD requirements 5

Note: Since this is healthcare (I-2 occupancy), OSHPD has additional jurisdiction. The fire alarm system must integrate with the nurse call system per NFPA 72 §24.5 6.

New York has notable differences from California for this building type:

Key conflict: NYC requires dual independent water supply connections, while California allows a single connection with on-site tank backup.

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Smoke control for atriums in high-rise healthcare is governed by several intersecting codes:

IBC §909 Smoke Control Systems 10:

• Atriums connecting more than 2 stories require engineered smoke control
• System must maintain tenable conditions for 20 minutes minimum
• Makeup air velocity ≤ 200 fpm at any door

NYC-Specific Requirements 11:

• NYC BC §909.1 requires peer review of smoke control design by a registered design professional
• More stringent testing requirements: 3 annual tests vs. IBC's 1

Critical Design Note:

For healthcare atriums, NFPA 92 §4.4 12 governs the engineering analysis. The exhaust rate calculation must account for:

• Sprinklered vs. non-sprinklered fire
• Fuel load of furnishings (per NFPA 92 Table A.2.4.2)
• Glass atrium enclosure thermal breakage risk