Insights
Real numbers and senior-PM thinking on commercial construction in North Texas.
Plain English. Cited sources. Updated when a question surfaces often enough to deserve a full post.
22 posts
- Cost Benchmarks
DFW Medical TI Cost Benchmarks for 2026
What a 3,000–8,000 sf dental or medical practice in DFW actually costs to build right now — and the three drivers that move that number most. Includes a real value-engineering example from KVC Pediatric Dentistry.
May 2026 · 6 min read
- Process
True Design-Build vs. Design-Bid-Build: how holes and busts cost doctors six figures
Most contractors give a fake-low SF price up front, then bury you in change orders for the holes and busts in the architect's plans. Here's what 'true design-build' actually changes.
May 2026 · 7 min read
- Permitting
How KVC Pediatric Dentistry got a permit in 1 month against an 8-month city backlog
Dr. Velasquez and Dr. Chen had hired an expensive dental consultant who couldn't get them moving. Here's how Pereff's city relationships changed the timeline by 7 months.
May 2026 · 5 min read
- Cost Benchmarks
What it actually costs to build a veterinary hospital in DFW (2026)
A small animal clinic and a full-service emergency veterinary hospital are not the same project. Here's a DFW-specific breakdown of vet hospital construction costs by facility type — and the four drivers that separate a $400K finish-out from a $3M ground-up.
May 2026 · 7 min read
- Cost Benchmarks
DFW Dental Build-Out Cost in Collin County (2026)
What a dental practice in Plano, Frisco, McKinney, or Allen actually costs to build right now — the real per-SF bands, the three line items that move the number most, and a value-engineering example from KVC Pediatric Dentistry.
May 2026 · 8 min read
- Cost Benchmarks
Veterinary Clinic Construction: 7 Things That Blow the Budget
A vet clinic is one of the most MEP-intensive buildings a practice owner will ever finance — and the budget blowers are almost never the things people plan for. Here are the seven that turn a clean estimate into a painful one.
May 2026 · 9 min read
- Comparison
Design-Build vs. Design-Bid-Build: Where the Change Orders Hide
Design-bid-build doesn't fail at construction — it fails at the contract seam between the architect and the builder. Here's the exact mechanism that turns a 'low bid' into the highest number on the table, and what True Design-Build changes about it.
May 2026 · 8 min read
- Comparison
CMAR vs. Design-Build for Healthcare Owners
Both methods bring the builder in early and both can deliver a guaranteed maximum price — so where they actually differ is who holds the design risk and when the GMP gets locked. A straight comparison for owners building dental, medical, and surgical facilities in DFW.
May 2026 · 8 min read
- Financing
How 90% LTC Financing Actually Works on a Commercial Ground-Up
High-leverage construction financing is real — but it's the bank's money, the bank's underwriting, and the bank's decision. Here's how loan-to-cost works on a ground-up commercial project, what a draw schedule actually does, and why Pereff facilitates the relationship instead of lending the money.
May 2026 · 8 min read
- Financing
SBA 504 vs. 7(a) for Owner-Occupied Commercial Real Estate
If you'll occupy the building you're buying or building, an SBA loan is often the best tool you have. Here's an honest, plain-English breakdown of the 504 vs. the 7(a) — structure, rates, owner-occupancy rules, and the 2026 cap change — plus where Pereff fits (we facilitate the bank relationship; we don't lend).
May 2026 · 8 min read
- Permitting
DFW Commercial Permit Timelines by City (2026)
How long a commercial permit actually takes in Plano, Frisco, McKinney, Allen, Prosper, Richardson, Dallas, and Fort Worth — a city-by-city window for 2026, plus why the same drawings clear in three weeks in one city and twelve in another.
May 2026 · 8 min read
- Permitting
What Frisco's 2024 IBC Adoption Means for Your Commercial Build
Frisco adopted the 2024 International Building Code with local amendments effective March 1, 2026. Here's what the new code cycle changes, why your code year is a planning decision and not a footnote, and how first-submittal discipline keeps a code change from costing you a resubmittal.
May 2026 · 7 min read
- Process
The DFW MEP Labor Squeeze and Your 2026 Construction Schedule
Electricians, HVAC fitters, and plumbers are the tightest trades in North Texas right now — and on a medical or restaurant build, MEP is the critical path. Here's how the squeeze shows up in your schedule and the four moves that protect your open date.
May 2026 · 8 min read
- Process
Why Owner-Operators Build Better Than GC-Only Firms
Most general contractors only know how to build. Stephen Pereff is also a real estate developer with 25+ years of city and bank relationships — and that changes what can be solved on your project. Here's the honest case for the owner-operator model, including where a GC-only firm is the right call.
May 2026 · 8 min read
- Permitting
How Frisco's 2024 IBC Adoption Affects Your Commercial Project Timeline
Frisco adopted the 2024 IBC effective March 1, 2026. Here's what changed and how to compress your permit timeline.
April 2026 · 4 min read
- Financing
When HUD 98% LTV Multifamily Financing Actually Makes Sense
Pereff's bank facilitation has unlocked HUD-insured financing for multifamily developers — 40-year fixed-rate non-recourse loans at up to 98% LTV. Here's what it actually is, who qualifies, and why Pereff is not the lender.
April 2026 · 7 min read
- Financing
100% financing for healthcare ground-ups: when it actually happens
Pereff's bank facilitation has unlocked 100% financing including soft costs for healthcare ground-up projects — most recently for Dr. Sheppard during a government political shutdown.
April 2026 · 6 min read
- Process
ICRA in dental construction: what doctors and their contractors get wrong
Infection Control Risk Assessment (ICRA) is a federal and accreditation-driven requirement when building or renovating in or adjacent to an active healthcare facility. Most dental contractors skip it. Here's what it actually requires — and when it applies to your project.
April 2026 · 6 min read
- Process
The 7 questions Pereff asks before quoting your healthcare TI — and why you should ask them of every GC
Most doctors pick a GC based on who gave the lowest per-square-foot number. These are the seven questions that separate a contractor who will deliver on budget and on schedule from one who won't — and how Pereff answers each one.
April 2026 · 7 min read
- Process
Why your first GC question should be the budget range, not the bid
Most doctors walk in asking three GCs to bid the same drawings. That's how you get the wrong number — and the wrong builder. The X-ray analogy explains why.
March 2026 · 5 min read
- Process
Should I lease or own my medical building? A DFW doctor's directional guide
This is the single biggest financial decision a doctor makes before signing a construction contract. Leasing feels safer. Owning builds wealth. Here's the framework Pereff uses to help doctors think through it — without pretending there's a universal right answer.
March 2026 · 8 min read
- Cost Benchmarks
Multifamily ground-up costs in DFW: per-door breakdown by structure type (2026)
Garden, mid-rise, or podium wrap — the structure type you choose determines your cost per door more than any finish decision. Here's a DFW developer's directional breakdown for 2026, with the financing angle that makes Pereff's multifamily program different.
March 2026 · 8 min read
Topics come from questions doctors and developers ask Pereff AI most often — when the same question surfaces repeatedly, we write it up with real numbers and cited sources. If your question isn’t here yet, ask Pereff AI directly.
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Pereff AI answers questions about cost, timeline, permitting, and financing — with cited sources.