Choosing between a 19,000 sf suburban building at $61/sf and a 9,400 sf medical office at $148/sf, and I cannot get the math to land the same way twice

What is the notice period on that renewal option, and is it long enough to backfill a 9,400 sf medical build-out?

The renewal option language is the whole game on the medical deal, agreed, but the number I'd want before anything else is what that 2021 rent resets to on exercise. If the option is fixed-rate and the delta to 2029 market is, say, $8-10/sf on 9,400 sf, you're looking at $75-94K of annual income you're effectively giving away for however many years that term runs, and that haircut changes your 6.1 cap in a hurry. On the suburban side, $180K in capex against a $1.16M buy is not trivial, but at least you're spending it to control the asset, not just hoping a single tenant makes one phone call your way. I've been in situations where the "safe" single-tenant deal turned into a 14-month vacancy at a building with very specific buildout that nobody else wanted, and the retenanting cost ate three years of NOI. What does the option actually reset to, fixed or CPI or fair market, and does the tenant have early termination rights buried in the same clause?

The gap between 6.1 and 7.4 looks like 130 basis points until you discount that renewal option, and then the two deals are probably trading at the same effective yield. Plateau corridor rents have moved hard since 2021, so by 2029 that tenant is sitting on a below-market option and they know it, which means you are not getting a renegotiation, you are getting an exercise. Laval suburban with $180K in capital and a real leasing job is still a cleaner position than waiting on one phone call.