Ok, so here's a very interesting idea. Wurm atm can only build on flat tiles, but how about we create foundation pillars that can create a surface to build on. The pillars will be created to your desired height (maybe some presets), you then add adjacent ones that will go to the same height. Now these will create a flat surface on the top to start adding floors. These foundation pillars will work like bridge supports where it calculates materials based on height etc.
Now for getting up onto the building, you can maybe start using a ground floor building that connects to the pillars. Heck, what if you started by using a building and expand by using a new floor type with pillars that work in the same way as bridges. So you just make your first floor without pillars on a flat surface then add adjacent ones.
The hardest part will planning it out. Do you have to create new tools? UI? Maybe use a surveying tool that you place on the first tile and then add in the direction you want?
Just throwing this out there, would be a lot of work but will most likely revolutionise how we build buildings
Cheers