North Carolina
Albemarle
Archdale
Asheboro
Burlington
Charlotte
Clemmons
Colfax
Concord
Durham
Fairview
Franklinville
Garner
Granite Falls
Greensboro
Harrisburg
High Point
Hillsborough
Kernersville
Liberty
Lenoir
Lexington
Madison
Matthews
Mebane
Mint Hill
Mocksville
Mt. Airy
North Wilkesboro
Pleasant Garden
Reidsville
Rural Hall
Statesville
Summerfield
Thomasville
Whitsett
Wilmington
Winston-Salem
South Carolina
Virginia
Danville
Roanoke
Suffolk
Wytheville
Medical
At Fourth Elm Construction, we have built a strong reputation in the medical construction sector throughout North Carolina, South Carolina, Virginia, and Tennessee. Our experience spans both ground-up healthcare facilities and complex interior upfits, always delivered with a focus on precision, compliance, and patient-centered design. We’re proud to have developed long-standing relationships with many repeat clients in the healthcare industry—ranging from private practices and specialty clinics to outpatient centers and surgical facilities. These trusted partnerships reflect our ability to consistently meet the unique demands of medical environments while delivering high-quality, efficient, and modern spaces that support exceptional care.
Automotive
The automotive industry is always evolving—and so are the dealership facilities that support it. At Fourth Elm Construction, we specialize in building and renovating automotive dealerships to align with shifting design trends, electric vehicle infrastructure demands, and evolving brand standards. With a proven track record across North Carolina we’ve completed successful projects for major brands including Hyundai, Kia, Nissan, Volvo, Lincoln, Mazda, Genesis, Ford, and Chevrolet. Our team understands the importance of speed, precision, and brand consistency, which is why dealers continue to trust us with repeat business. From showroom updates to full dealership builds, we partner closely with auto groups and manufacturers to deliver spaces that reflect the future of automotive retail.
Industrial
At Fourth Elm Construction, we’re proud to support the growing manufacturing sector across North Carolina, South Carolina, Virginia, and Tennessee with expert construction services tailored to today’s evolving industrial needs. We’ve partnered with both owners and developers to deliver facility expansions, speculative warehouse builds, and custom industrial projects that meet the demands of advanced manufacturing. From complex electrical and mechanical systems to clean room environments and compressed construction schedules, our team brings precision, flexibility, and a deep understanding of operating within active facilities. With a strong safety culture led by our Safety Manager, Bobby Bulla, we’re committed to maintaining safe, efficient job sites—especially in live manufacturing environments. As the region’s industrial market continues to expand, Fourth Elm is prepared to grow alongside it by delivering innovative, high-performance solutions for our clients.
Office
At Fourth Elm Construction, we specialize in delivering high-quality office construction projects across North Carolina, South Carolina, Virginia, and Tennessee. Our experience includes everything from ground-up corporate headquarters to interior renovations and speculative suite buildouts. As workplace trends continue to evolve, we partner with owners, developers, and landlords to create modern office environments that prioritize flexibility, functionality, and unique design features. From sleek executive offices to multi-tenant spaces, we’ve completed a wide range of projects that reflect today’s office demands. Our team understands how to navigate complex schedules, tenant needs, and high-end finishes to deliver office spaces that support productivity, culture, and long-term value.
Retail
Retail and mixed-use construction is a cornerstone of Fourth Elm Construction’s portfolio across North Carolina, South Carolina, Virginia, and Tennessee. From boutique shops and upscale retail environments to restaurants, breweries, and national brands like Starbucks, our team brings deep expertise and attention to detail to every project. We understand that successful retail spaces must blend design, functionality, and customer experience—whether it’s a ground-up build or a custom interior fit-up. Our team takes pride in delivering thoughtfully executed spaces that reflect each client’s vision while supporting long-term business success. With a focus on quality craftsmanship and seamless project delivery, we help bring vibrant, high-performing retail and mixed-use environments to life.