Located across from Providence Saint Joseph Mission Hospital, this project involved substantial earthwork and retaining walls to transform an existing hillside into an area suitable for the construction of a new ground-up 108,000 s.f. 4-story Medical Office Building (MOB) and 5-story, (611) stall design-build parking garage. Extensive site work included road reconfigurations and a combination of various design-build retaining wall systems including Soil Nailing, Beam and Lagging, and Mechanical Stabilized Earth (MSE) walls as high as 55 feet tall that were highly decorated to match the City of Mission Viejo style. The MOB was supported using deep foundations (CIDH piles) with a bolted Side-Plate structure, and the exterior was skinned with curtainwall, punched windows, aluminum composite panels, and Expanded Insulating Foam System (EIFS) providing continuous exterior insulation and an elegant, welcoming appearance. Floors #1 and #2 were built to OSHPD-3 standards.