To applause and cheers Monday night, the Palo Alto City Council green-lighted Stanford University's massive hospital expansion, a project expected to reshape health care in the area.

It was a landslide victory for Stanford after four years of intense debate and negotiations, as council members approved various ordinances, permits and resolutions in a series of 8-0 votes.

"It's a night for celebration in Palo Alto," Council Member Greg Schmid said. "Anyone with a past in Palo Alto has had their lives intersect with the hospitals, and some of us are here because of the hospitals. It's also an acknowledgement that as a 21st-century community, for the next generations it's essential to have a hospital like that available."

Council Member Larry Klein said he abstained from voting because his wife works for Stanford.

The $5 billion project will add a total of 1.3 million square feet to Stanford's hospital, clinic and office space. It will reshape almost every aspect of Stanford's medical facilities, including Stanford Hospital, Lucile Packard Children's Hospital, the School of Medicine and the Hoover Pavilion. It has also been the subject of an exhaustive city review process.

"After four years and 96 meetings, I have nothing more to say," Council Member Pat Burt quipped.

Plenty of community members, Stanford doctors and local politicians did have more to say; about 20 of them described the importance of the hospitals and renovations to a packed council chambers. Stanford officials said they need to modernize and expand the hospitals to meet state seismic standards and patient demand.

Dr. S. V. Mahadevan, medical director of the hospital's emergency department, said the hospital's operations are "truly hampered by our current physical plans."

In the emergency department, he said, "our hallways are cluttered with patients and medical equipment. ... We do not have enough room to care for patients with the dignity and privacy they deserve."

The project will add 144 patient beds to Stanford Hospital and 104 to Lucile Packard, and allow patients to have private, individual rooms.

Former 49ers quarterback Steve Young made an appearance, urging council members to support the hospital.

"In how many communities can we say that our community hospital is one of the world-class hospitals in existence," Young said.

In exchange for approving the project, Palo Alto negotiated a development agreement that includes nearly $175 million in "community benefits" to be provided by Stanford, such as Caltrain passes for hospital employees and about $23.2 million for the city to use on housing projects.

The agreement was the subject of the night's only hiccup, when Schmid wanted to add a provision requiring the city to monitor traffic increases at intersections near the hospital. Stanford's plans to reduce traffic only focus on employees, Schmid said, while an increase in the number of patients and visitors could also cause traffic.

Stanford representatives told the council the language was ambiguous and it would be a "significant concern" if it were added to the agreement. City staff said they already regularly monitor intersections, and no other council members supported Schmid's idea.

Following Monday's approval, Stanford plans to begin construction this summer with preparatory work such as upgrading utilities along Welch Road, Michael Peterson, Stanford's vice president for special projects, said last week. The new buildings at Stanford Hospital and Lucile Packard should be open by early 2018, he said.

"I think often we lose track of what we're really doing here," Council Member Gail Price said Monday. "It's about creating an environment, creating a site, a facility, that has meaning for people. That provides real, caring and passionate health care for human beings, our generation and those to follow us."

Email Diana Samuels at dsamuels@dailynewsgroup.com.