This five-story, core and shell medical office building is located in Short Pump, VA. This building was a Design-Build effort that included (3) DX Rooftop Units with gas heat feeding terminal boxes on each floor. Interior plumbing consisted of (8) wet stack risers to serve future tenant build-out and primary storm drains with overflow scuppers on the roof. While completing the design and subsequent construction for the core and shell building, the tenant design was also being developed, which meant quick changes had to be implemented to better suit the expected tenants’ needs.