Thirty-five years after setting its sights on San Marcos, Scripps Health announced Monday that it will soon break ground on a medical campus within walking distance of a competitor, Kaiser Permanente San Marcos Medical Center. The site, which has already been graded and had underground utilities installed, would include a 200- to 250-bed full-service hospital and a 150,000- to 200,000-square-foot ambulatory care building. The project, which still needs permits from the City of San Marcos, would start with the ambulatory building. The hospital is not expected to open until roughly 2031. The project is estimated to cost about $1.2 billion.