We’re a San Francisco–based construction management firm specializing in healthcare, multifamily development, and tenant improvement projects. We serve as trusted owner’s representatives, managing every phase of design and construction with precision, transparency, and accountability.
From complex, compliance-driven healthcare projects, high-density residential communities, and stunning tenant improvement build outs, our team brings decades of experience to ensure every project is delivered on time, on budget, and to the highest standards of quality.
We oversee healthcare construction projects across Northern California, providing the deep regulatory understanding and attention to detail that medical facilities demand.
Our team manages every stage, from early design and HCAI permit strategy through construction and close-out, ensuring compliance, safety, and operational continuity for hospitals, clinics, and medical office buildings.
We coordinate directly with key stakeholders to align complex systems, maintain infection control standards, and keep projects moving efficiently through every HCAI milestone.
Whether it’s a new diagnostic suite, infrastructure upgrade, or phased renovation within an active facility, we ensure that every healthcare environment is delivered to specification, schedule, and standard.
From urban infill projects to large-scale apartment communities, Elm Street provides owner’s representation that brings clarity, control, and confidence to multifamily development.
We manage ground-up construction, adaptive reuse, and value-add renovation projects—ensuring that budgets, schedules, and quality standards remain on track from pre-development through occupancy.
Our multifamily expertise includes entitlement coordination, design team management, financial oversight, and construction phase leadership. We bring structure to complex developments, working closely with owners, lenders, and contractors to safeguard investments and maximize project value.
We support developers and business owners through the successful delivery of commercial and mixed-use environments that shape the modern Bay Area landscape.
Our background spans tenant improvements, retail centers, offices, and civic facilities—projects that require strategic coordination and cost control without sacrificing design intent.
We work as an extension of the owner’s team, managing contractors, budgets, and schedules to ensure projects meet operational needs and long-term performance goals.
With an emphasis on clear communication and proactive problem-solving, we help clients achieve efficient builds and lasting value in every commercial development.
We’re a leading commercial construction management firm in San Francisco with proven experience across public and private sectors.
