Fillable APPLICATION For Office Use Only P.O. Box 1687 (Town of Jackson, Wyoming)

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APPLICATION For Office Use Only P.O. Box 1687 (Town of Jackson, Wyoming)

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ONE AND TWO FAMILY BUILDING PERMIT
APPLICATION
Planning & Building Department
150 East Pearl Ave.
P.O. Box 1687
Jackson, WY 83001
ph: (307) 733-0440
www.townofjackson.com
For Office Use Only
Permit No:
Date Received:
Date Due:
INSTRUCTIONS.
This application form is for one and two family homes and their associated accessory buildings only. If you wish to construct a
commercial or multifamily dwelling, please use the commercial application form. Separate permits are required for plumbing,
mechanical, and electrical.
Complete all portions of the application. All items shall be shown or noted on the plans, including not applicable items. Sign the
application. Include all attachments. Submit the application to the Planning and Building office at Town Hall.
PROJECT INFORMATION.
Physical Address:
PIDN:
Zoning District:
Zoning Overlay District:
PROJECT DESCRIPTION AND PURPOSE. Describe the precise nature of the proposed use (i.e. single family home with garage,
ARU, etc.)
NEW
ADDITION
ALTERATION
REPAIR
IF REQUIRED, GRADING PRE- APPLICATION NUMBER:
PROPERTY OWNER.
Property Owner:
Phone:
Mailing Address:
ZIP:
E-mail:
APPLICANT/AGENT. (If other than owner)
Name:
Phone:
Mailing Address:
ZIP:
E-mail:
*If applicant is other than owner, a notarized Town of Jackson Letter of Authorization must accompany this application. Only the
Owner or their authorized agent may sign the application.
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Effective 4/19/19
CONTRACTOR.
Name:
Phone:
Mailing Address:
ZIP:
E-mail:
License:
PLANS DESIGNER.
Name:
Phone:
Mailing Address:
ZIP:
E-mail:
License:
ENGINEER or LANDSCAPE ARCHITECT. Required for Projects that require Plan Level Grading Information.
Name:
Phone:
Mailing Address:
ZIP:
E-mail:
License:
GRADING INFORMATION
All required grading information for a Statement Level or Plan Level grading project shall be submitted with the building
permit. NO separate grading permit is required.
Projects that require Plan Level grading information require a Grading Pre-Application.
There are two levels of grading information. Required information shall be the most rigorous requirement that applies.
1. Statement Level Grading The purpose of the statement level grading information is to allow the Town Engineer to review
land disturbances that, while small in area, may impact other landowners and the environment.
2. Plan Level Grading All plan level grading information shall be prepared by a professional engineer or landscape architect
registered in the State of Wyoming, unless exempted by the Land Development Regulations
Below, identify the area of disturbance or % impervious in each slope category:
REQUIRED GRADING INFORMATION LEVEL
GRADING PROPOSAL
% Impervious
OR
Area to be
Disturbed,
(sf)
EXEMPT STATEMENT PLAN
Disturbance location See LDRs See LDRs Within required yards
Total site proposed impervious surface See LDRs See LDRs
≥ 41%
Total land disturbance See LDRs
≥ 600 SF and
< 3,000 SF
≥ 3,000 SF
Disturbance of Slopes ≤ 5% < 600 SF
≥ 600 SF and
< 3,000 SF
≥ 3,000 SF
Disturbance of Slopes > 5% & ≤ 15% < 400 SF
≥ 400 SF and
< 1,000 SF
≥ 1,000 SF
Disturbance of Slopes > 15% N / A ≤ 800 SF
≥ 800 SF
**Pre-Application Required**
PERMIT LEVEL DETERMINATION
IS A GRADING PRE-APPLICATION REQUIRED?
Yes
No
DESIGNATED PRIMARY CONTACT. Please check below.
Property Owner
Applicant/Agent
Contractor
Plans Designer
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Effective 4/19/19
RETAINING WALLS AND FACINGS:
Height is measured from the bottom of the foundation and administered under the building codes.
All retaining walls or facings in excess of 48 inches shall be designed by a professional engineer registered in the State of Wyoming
and shall be submitted with a building permit.
PROPOSED ACCESS: If proposed construction site is accessed by a State or County road, not within the jurisdictional authority of the
Town of Jackson, an approved road access permit must accompany this application. Please contact:
Wyoming Department of Transportation
1040 E. Evans Lane, Jackson 733-3665
Teton County Road Department
3190 S. Adams Canyon Dr., Jackson 733-7190
FLOODPLAINS AND SPECIAL FLOOD HAZARD AREAS.
Is the site or structure located in a floodplain or in close proximity to Cache Creek or Flat
Creek?
YES NO
A Floodplain Development Permit is required before construction or development begins within any Special Flood Hazard Area
(SFHA). Development is any man-made change to improved or unimproved real estate, including but not limited to buildings or
other structures, mining, dredging, filling, grading, paving, excavation or drilling operations or storage of equipment or materials.
Development within the flood way is prohibited. Fill is prohibited within the floodway unless it has been demonstrated and
certified that it will not result in any increase in flood levels. If you are unsure if your site is located within the 100- year floodplain
or within a Floodway, please contact the Town Engineer / Floodplain Administrator, 307 733-3079.
Buildings located within the 100-year floodplain are required to provide an elevation certificate (FEMA Form No. 3067-0077)
proving the first floor of the structure is elevated one foot above the base flood elevation. For additions or alterations to an
existing structure, provide an elevation certificate for the first floor of the existing structure.
GROSS SQUARE FOOTAGE TABULATION
Please note that these measurements shall be calculated by using the exterior dimensions.
Existing
Proposed
1
st
Floor
2
nd
Floor
3
rd
Floor
Basement
Garage
Attached ARU
FIRE SPRINKLER REQUIRED? Note: The Town of Jackson requires all structures in excess of 5000 square feet to be fire sprinklered.
Yes
No
HEAT SOURCE
Identify type of heat source (such as gas, oil, electric base
board, electric forced air, etc.):
3 of 9
Effective 4/19/19
UTILITIES:
Water Meter Size(s):
☐
¾-inch
☐
1-inch
☐
1 ½-inch
☐
2-inch
☐
3-inch
Will there be an irrigation system? Yes
No
If Yes, will there be a separate meter?
Yes
No
Size of irrigation meter?
ESTIMATED COST OF CONSTRUCTION: (Required)
CERTFICATE OF OCCUPANCY IS REQUIRED
Before occupying your home, you must have a final inspection by the Building Department. Following this inspection, a
Certificate of Occupancy will be issued.
APPLICANT’S SIGNATURE, CERTIFICATION, AND AUTHORIZATION
Under penalty of perjury I hereby certify that I have read this application and state that, to the best of my knowledge, all of the
information herein is true and correct and I swear that any information which may be hereafter given by me in hearing before the
Planning Commission of Town of Jackson or the Town Council of the Town of Jackson shall be truthful and correct. I agree to
comply w
ith all Town, State, and Federal laws relating to the subject matter of this application and hereby authorize
representatives of the Town of Jackson to enter the property described herein during normal business hours, after making a
reasonable effort to contact the owner/applicant prior to entering the property.
In signing this application, I acknowledge that the Town's acceptance of this application and a plan review fee does not constitute
approval of a permit. I agree not to commence any work for which this application is being made prior to approval of this
application by the appropriate Town agencies and payment of any fees due.
Signature of Owner or Authorized Applicant/Agent
Date
Name Printed
Title
4 of 9
Effective 4/19/19
BUILDING DESIGN CRITERIA
All buildings are to be designed to the requirements of the current adopted International Residential Code. The design criteria
information should be shown on the submitted plans.
APPLICANT’S GUIDE TO SUBMITTAL MATERIAL
Plans required to be ¼” = 1’ scale (except for details, which may be shown at a larger scale). All pages shall be on 24 X 36 inch
paper. For other plan sizes please contact the Building Department. Each drawing shall bear a Title, a Scale, and North Arrow, as
appropriate. On building elevations, the building height shall be shown and dimensioned. Plans for alterations, minor additions,
decks and/or repairs may deviate from these requirements with approval from the Building Official.
Please submit building plans and corresponding documents electronically to townbuilding@jacksonwy.gov.
PLAN SUBMITTAL REQUIREMENTS
Cover Sheet (See below for more detail.)
Building Elevations
Site Plan (See below for more detail.)
Plumbing Plan
Utilities Plan
Mechanical Plan
Floor Plans
Framing Plan
Roof Plan
Foundation Plan
Energy Calculation (Rescheck)
Stamped Structural Engineered Plans (if required)
Stamped Structural Calculations (in PDF format)
COVER SHEET REQUIREMENTS
SITE PLAN REQUIRMENTS
Project Name & Address
Engineering Scale and North Arrow
Project Owner & Address
Property Lines (With Bearings & Dimensions)
Plans Preparer, Address & Phone
Easements
Vicinity Map
Dimensioned Setbacks
Zoning District And Overlays
Adjacent Street Names
Building Occupancy / Use
Adjacent Public Improvements
Lot Area (Square Feet)
Parking (Existing And Proposed)
Existing & Proposed Number of Stories
If surveyed, coordinate system and datum
(List for Each Floor & Basement)
Snow Storage Location
Existing & Proposed Floor Area
Grading Permit Checklist Information
(List for Each Floor & Basement)
Grading Pre-Application Information
Total Floor Area (Including Basement)
Type of Construction Per The IRC
Listing of The International Codes Utilized In The Design Of The Building
Design Criteria Utilized (Seismic Zone D, 93 Psf Ground Snow Load, 115 Mph Wind Load)
Notation as To Whether Fire Sprinklers Are Being Proposed For Use
LAND DEVELOPMENT REGULATIONS (LDR) SUBMITTAL REQUIREMENTS
Please see attached addendum for submittal requirements to demonstrate compliance with Town zoning requirements.
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Effective 4/19/19
Town of Jackson Building Permit: Exterior Lighting Submittal Requirements
(For Commercial and Residential)
Address:
__________________________________________________________________________________________________
In addition to completing the tables below, you will need to submit manufacturers’ product specification sheets for all proposed
outdoor lighting and a lighting plan showing the location and height of all proposed exterior lighting. Commercial applications shall
include description of adaptive controls and plan for lighting reduction. Complex uses may require additional information.
PROPOSED LIGHTING:
Fixture Model or
Description
No. of
Fixtures
Shielded
(Y/N)
Light Color
(Kelvin)
Max Lumen per
Fixture
Lumens Total
Ex: Cornice PS634 sconce
3
Y
3000
623
1869
Existing Exterior Lighting (complete to the best of your knowledge)
Fixture Model or
Description
No. of
Fixtures
Shielded
(Y/N)
Light Color
(Kelvin)
Max Lumen per
Fixture
Lumens Total
Ex: Cornice PS634 sconce
3
Y
3000
623
1869
Lumen Total (Existing & Proposed)
*If you need additional space to detail your exterior lighting fixtures, please submit on a separate page
Is your exterior lighting contained entirely on your property? ☐ Yes ☐ No
Exterior Lighting Requirements (Sec. 5.3.1 of the Land Development Regulations)
Shielding. All lights over 600 lumen must be shielded so that light is directed downward (see picture on reverse side). A lumen
measures the brightness of a light and is indicated on lighting packaging. A standard 60 watt light bulb is roughly 800 lumens.
Illumination per sq ft limits. Illumination is limited by how much existing or proposed impervious surface (pavement, building
footprint, decks, gravel, etc) you have on your property.
Zone
Lumens/sq ft
Example
DC, CR-1, CR-2, CR-3, OR, TS, UC, BP-ToJ,
MHP-ToJ, P/SP, P-ToJ, NL-5, NM-2, NH-1
3
A commercial property with 32,395 sq ft of impervious
surface is allowed 97,185 lumens (32,395 X 3)
R-ToJ, NL-1, NL-2, NL-3, NL-4, NM-1
1.5
A property with 5,500 sq ft of impervious surface is
allowed 8,250 lumens (1.5 X 5,500)
Light Color. All lights must be equal to or below 3000 K. Correlated color temperature refers to the ‘color’ of the light emitted. It
is indicated on lighting packaging.
Light trespass. Don’t shine light into your neighbor’s yard.
Pole Height: Lights mounted on a standalone pole cannot be greater than 15 ft in height.
Prohibited Lights. No flickering or flashing lights, no searchlights or laser lights, no strings of lights (unless between Nov 1 and
April), or singular lights having 20,000 lumens or more.
Controls & Lighting Reduction. All nonresidential properties shall use automatic lighting controls to extinguish lighting or reduce
total exterior lighting by 30% by 12:00 am. Lights should be extinguished during the day when there is sufficient daylight.
6 of 9
Effective 4/19/19
0
0
0
0
0
0
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Effective 4/19/19
ONE AND TWO FAMILY BUILDING PERMIT
Submittal Requirements for Compliance with
Town Land Development Regulations (LDRs)
150 East Pearl Ave.
P.O. Box 1687
Jackson, WY 83001
ph: (307) 733-0440
www.townofjackson.com
In addition to the information required to comply with the Building Code, all building permit applications
must clearly demonstrate compliance with all applicable development standards in the Jackson Land
Development Regulations (LDRs) (e.g., affordable housing, parking, height, setbacks, etc.). This is
especially important for projects that submit directly for a building permit without prior approval of a
Development Plan or other development permit.
All proposed projects must either submit the required material below or clearly explain why the
information is not relevant or applicable to the project.
TIP: Applicants are encouraged to have a pre-submittal meeting with the Planning and Building Dept.
staff prior to submittal of a building permit http://townofjackson.com/178/Planning-Building. This is
especially true for large and more complex projects.
LDR Submittal Requirements
Project Narrative: A clear narrative that succinctly describes the current site conditions and all major
elements of the proposed project, including a list of relevant previous development approvals.
Summary Table of LDR Compliance: A table that summarizes compliance with all major dimensional
standards (e.g., setbacks, FAR, LSR, height, parking, etc.). See sample table on back of sheet.
Summary of Proposed Uses: Provide floor area of all proposed uses in the project per the Use Table in the
zone and demonstrate compliance with any use-specific standards in Sec. Div. 6.1;
Separate use permits are required for all proposed uses. Use permits may be submitted prior to,
concurrent with, or after building permit.
Pedestrian Frontage requirements (Character Zones only): Demonstrate compliance with the applicable
pedestrian frontage (sidewalk) standards in Sec. 2.2.1.C.
NOTE: Applicant must identify the location of the curb (even if none currently exists) before the
location of the sidewalk or building can be determined. Consult Planning Department if necessary.
Building Frontage requirements (Character Zones only): Demonstrate compliance with the applicable
building frontage standards in Sec. 2.2.1.D.
Landscape Plan: A landscape plan that complies with Div. 5.5, including plans stamped by a Wyoming
licensed landscape architect and a bond for 125% of the value of the required landscaping.
Housing Mitigation Plan: A housing mitigation plan that complies with Sec. 6.3.6, Housing Mitigation Plan
and Housing Mitigation Agreement (see housing mitigation calculator on Planning Dept. website).
Workforce Bonus: Demonstrate compliance with workforce housing floor area bonus (Div. 7.8), if used
Housing Mitigation Deed Restrictions: If the project includes deed-restricted housing units (required or
voluntary), deed-restrictions must be signed and recorded prior to building permit approval.
Design Review Committee (DRC): If required by Sec. 5.8.1, applicant shall obtain DRC review/approval prior
to final approval of building permit. Contact Planning Department for DRC schedule.
Resubmittal/Amendment: All significant changes from previous submittal shall be clearly summarized.
Any other Development Standards: Demonstrate compliance with all other applicable LDRs.
8 of 9
Effective 4/19/19
Table of LDR Compliance
General Standard
LDR Standard
Existing
Proposed
Floor Area Ratio (FAR)
Landscape Surface Ratio (LSR)
Height
Front Setback
Side Setback
Side Setback
Rear Setback
Parking Spaces
Other?
Comments:
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Effective 4/19/19
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APPLICATION For Office Use Only P.O. Box 1687 (Town of Jackson, Wyoming)

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Completed 21 September 2021

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