Based on the California Pacific Medical Center Long Range Development Plan, the city’s largest private hospital made plans for significant construction on four campuses and construction of a large new hospital. The variety and scale of the structures and campuses vary from the Gothic Revival St. Luke’s campus to the urban mixture of Classical and Brutalist architecture at the Pacific campus, the Art Deco at the California campus, and the Mid-Century Modern context in the area of new construction. The extensive development of these campuses required study through the California Environmental Quality Act (CEQA) process. Knapp Architects was commissioned to prepare Historical Resource Evaluation Reports and the Cultural Resources section of the associated EIRs as consultant to multiple environmental firms over the course of several years. Knapp Architects evaluated specific buildings to determine their historical significance and also larger areas to determine if historic districts could be defined, in addition to consulting on the impact of demolition and new construction.