I can't answer all your questions, but hopefully others can add to what I know...
I have little experience with extensions. I did apply for one after I sent my PR app, but I got my PR before they ever starting processing the extension app. I do have a spousal app american friend who has been in process 20 months now. I will see tomorrow, and I will ask her about what she put as the reason and the length of her extensions.
Remind me again...You'll be common law in September and need to apply for an extension of your temp status when?
As far as evidence...
1. I wouldn't worry too much about the number of photos (I only submitted 9 or so, others submit 100s). I think you should focus on variety, passage of time, and photos that include either of you with friends or family at events in which you both participated. If you need to fill in the gaps for those types of photos, do it NOW!
2. Lease and shared utilities is good. You can get a CAN bank account (we got a joint account from RBC before I was a PR without any problems), and I recommend you do because it demonstrates a combining of financial affairs (see back to the OP 2 manual section 5.26 about mutual commitment to a shared life and those 4 interdependencies they look for in an app).
3. Letters from both sides of the family are great (don't sweat it if not everybody is willing to do it for you). You will need two that are notarized and you can include more (notarized or not) if you want. I sent 8-9. I will send you a private message with the letter I wrote to friends and family when I requested that they do this for us.
4. Evidence of gifts, anniversary celebrations (however small and "cheesy") and trips are excellent pieces of evidence as are any cards, letters, email, chat, state updates, phone records (of course).
5. Actually, it would be ok to send your app without the FBI clearance letter, but since you are months away from submitting I suggest you just try to time the request based on the FBI's current processing times to get the letter just before you submit. But the MEDICAL EXAM MUST BE DONE BEFORE SUBMITTING, and you will have to include a receipt of sorts to prove it. Otherwise, you are likely to get your app sent back to you because it is incomplete. They seem to be lenient on the FBI letter because of the processing time, but NOT lenient about the medical.
Being scared is a completely normal feeling. This process is hard, confusing, intimidating, etc and so much depends on how we put things together in the PR application. I know that doesn't make it any better, but it is the truth and A LOT of people feel exactly the same way you do. Try not to worry. I will send you a private message suggesting how to organize your application. It is only meant to be helpful; take from it what you will.
Ok, lastly, there are some great resources for American's in our area (Hamilton is not that far from where I live in Mississauga) and I even have one American female friend who lives in Hamilton. I can get you two connected if you want. One resource is the American Women's Club of Oakville. I just connected with this group myself as I have found it hard to make friends here and these are warm supportive outgoing people who plan lots of events. Also, there is a Meetup group (www.meetup.com has lots of groups of ALL sorts) called the Toronto Expat Americans who do events monthly. Meetup and my library card were lifesavers to me when I was here waiting out the process. There are also Facebook groups you can request to join. I recommend "Americans in Canada" as they are very supportive and talk about immigration is frequent.
So, that is enough for know, eh? Let me know if I can help in any way.
Allison