The region’s second-largest start was the Honolulu Authority for Rapid Transportation’s $1.66-billion Honolulu Skyline Rail, Segment 3. When complete in 2030, the extension will add three miles of elevated guideway and six stations through Honolulu’s City Center.

Another Olympic-size project is the $1.5-billion Los Angeles Airport’s (LAX) Roadway Improvements, part of Los Angeles World Airports’ $30-billion capital improvement program and the final phase of the Airfield and Terminal Modernization Program Roadway Improvement Project. Aimed at easing flow in and around the airport ahead of 2028’s anticipated spike in visitors, the 4.4-mile scope includes reconfigured roads and bridges, retaining walls, drainage, lighting, signage and intelligent transportation systems. Ingress roadways will be completed first, ahead of the games, then the egress roadways by 2030.

Meanwhile, the race to upgrade hospitals to meet looming compliance deadline continues. In 1994, the California Legislature passed SB 1953 after the Northridge earthquake, mandating that all hospital buildings must be able to remain standing after a powerful earthquake by 2020 and be fully operational after such an event by 2030.

Spanning 18 acres, the $1.5-billion Kaiser Permanente Railyards Medical Center is a full-service hospital in downtown Sacramento set to open in 2029. Work includes an eight-story, 662,050-sq-ft, 310-bed hospital and five-story, 173,000-sq-ft medical office building. This facility will be one of the state’s first all-electric hospitals and will replace the existing 60-year-old hospital on Morse Avenue, thus bringing Kaiser into seismic compliance.

Over in San Jose, Good Samaritan Hospital invested $1.3 billion to expand its hospital campus and meet seismic safety standards. The project is one of the largest health care investments in Santa Clara County history, spanning 715,144 sq ft and including a new patient tower, structured parking and infrastructure upgrades.

Community Regional Medical Center’s Fresno campus is undergoing a $350-million seismic retrofit as well, rounding out the health care-related top starts.

Kuilei Place will feature two towers: the mid-rise tower, which spans Floors 2–12, and the high-rise tower, which reaches up to Floor 43.
Rendering courtesy Kobayashi Group

Just one mixed-use project appeared this year, the $619-million Kuilei Place Housing Tower in Honolulu. Featuring 43 floors and 1,005 units, Kuilei Place will see about 60% of its units go to affordable housing, while the rest will go as market units.

Another Top Starts staple is energy. Solar energy construction began last year with a pair of projects: the $416-million Jacumba Valley Ranch Solar Energy Park in California and the $287-million Appaloosa Solar Facility in Pomeroy, Wash.

Up in Oregon, Sierra Pacific Industries has invested $253 million in upgrades to its sawmill facility in Eugene, which will make the complex one of the largest in the country, with an annual production capacity of 650 million board ft when construction is complete in 2028.

Although it just missed this year’s ranking, the $137-million Port of Seward modernization project in Alaska shows construction is advancing in the far north as well. The 41,500-sq-ft cruise terminal’s scope includes a state-of-the-art floating double-berth pier at 100 ft wide and 748 ft long, along with a 200-ft-long split-transfer span.

This collection of projects mirrors nationwide trends. Nonbuilding construction starts rose in 2025, up 18.7% year-over-year, according to Dodge Construction Network. Total starts were up 5.4% and nonresidential starts up by 4.5%, but residential starts sank 4.8% for the year. Just one residential project made this year’s list: the $170-million Naliko Residential Community in Kapolei, Hawaii.