Determine the cost of construction (hiring a contractor in the GNO area is going to start around $165-175/sqft to build) and be sure to include all holding costs, as well as interest in the loan.

Readers should seek professional advice.

Readers should seek professional advice.

Readers should seek professional advice.

If you're certain the type of renter you're going to get are traveling medical professionals, you know they're on short term contracts (typically 13 weeks).

Michael,   A good book to purchase is "Professional Real Estate Development: The ULI guide to Business.   

If you can't perform to the new standard were setting, I strongly suggest stepping back and hiring one of us who are setting this new standard. 

HI,I was curious to hear from other professionals, when you have a tenant for a couple of years, and then he wants to add a new person to the lease, what steps would you take?

If additional funds are required or if a professional is unable to resolve the issue, Lula will reach out to you directly.Let me know if you have any questions! 

Hire a company/person that is solely a QI like @Dave Foster they do it every day and will keep you legal and on track.