The Cleveland VA Medical Center serves veterans in northeastern Ohio. The 800-stall four-level post-tensioned concrete parking structure was the first of several recent major projects on the campus and freed up surface parking lots to allow for subsequent building expansions. Much of the prime parking space is dedicated to handicapped parking to service the Medical Center’s high volume of outpatient care. The three 65-foot bay parking garage was designed for both vertical and horizontal expansion. The structure utilizes oneway post-tensioned concrete slabs and beams. The columns, stair towers and elevator cores are constructed of conventionally reinforced cast-in-place concrete columns. Due to the Medical Center’s low allowable soil bearing pressure, the concrete structure is supported on concrete strip footings with top and bottom reinforcement acting as continuous beams.