Fillable Form 83001: COMMERCIAL BUILDING PERMIT (BDC) APPLICATION Planning (Teton County Wyoming Government)

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Form 83001: COMMERCIAL BUILDING PERMIT (BDC) APPLICATION Planning (Teton County Wyoming Government)

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BDC Permit Application
1
Effective 1/1/2020
COMMERCIAL BUILDING PERMIT (BDC)
APPLICATION
Planning & Building Services Department
Building Division
200 S. Willow St.
P.O. Box
1727
Jackson, WY
83001
Phone: (307) 733-7030
www.tetoncountywy.gov
Fo
r Office Use
Only
BDC
SWF/SWP GEC
PLEASE CALL AND SCHEDULE A TAKE-IN WITH THE PERMIT TECHNICIAN BEFORE BRINGING IN THIS
APPLICATION.
Please type or fill out this application in ink
only.
PROJECT: In order to expedite the review, please attach to this application a narrative describing the nature of the businesses that
will occupy the proposed structure. Please describe the nature of the project below:
Business Name:
Days/Hours
of Operation:
Number
of
Employees:
Physical Address:_____________________________________________________________________________________________
Subdivision & Lot #:__________________________________________ PIDN#:___________________________________________
OWNER: A c
opy of the Warranty Deed or Contract of Sale must accompany this application.
Name: Phone:
Mailing Address: City, State:
Email: ZIP:
APPLICANT/AGENT: If the applicant is other than owner, a notarized Teton County Planning & Development Letter of Authorization
must accompany this application. Only the owner or his/her authorized agent may sign the application, correction list or
per
mit.
Name: Phone:
Mailing Address: City, State:
Email:
ZIP:
ARCHITECT: Wyoming State Statutes require an architect’s or engineer’s stamp on new commercial or multi-family buildings having
an occupancy load of 10 or more people.
Name: Phone:
Mailing Address: City, State:
Email: ZIP:
CONTRACTOR: Contractors are required to be licensed in the Town of Jackson. Commercial projects require general contractors to
hold at least a Class A or B license.
Name: Phone:
Mailing Address: City, State:
Email: ZIP:
License No.
BDC Permit Application
2
Effective 1/1/2020
USE AND DEVELOPMENT PERMITS: This application form is for commercial buildings, commercial remodels, and tenant
improvements. Please note, depending on the use and size of building, a Development Plan, Sketch Plan, Basic Use or
Conditional Use Permit may be required. A building permit plan review cannot be done concurrently with a Development
Plan, Sketch Plan or Conditional Use Permit review. Please speak
t
o a Planner if you have any questions regarding use and
development permits.
Please indicate any Use or Development Permits obtained for this project, including the date(s) of approval. If you are processing
applications concurrently, indicate that approval is pending.
Permit Number(s):
Date(s)
Approved:
WILDLAND URBAN INTERFACE: If a property is located within the Wildland Urban Interface, a Wildland Assessment is required prior
to submitting the building permit application. Contact the Fire Marshall at 307-733-4732 to arrange a meeting. The IWUIC
application is available online at https://www.tetoncountywy.gov/671/WUI-Information-for-Contractors
.
Is the property located in the Wildland Urban Interface?
FLOODPLAIN: See County Floodplain Management Resolution and Flood Insurance Rate Maps (FIRMs), which are available on
the County GIS Map Server https://maps.greenwoodmap.com/tetonwy/mapserver/.
If located outside of Flood Hazard Zone X,
a Floodplain Development Permit is required and may be processed concurrently with the Building Permit application.
What is the property’s Flood Zone Designation? Check all that apply:
A
AE
AO
X
Other
(please
identify):
If the designation is not Zone X, have you submitted a Flood Plain Development Permit Application to Engineering?
GRA
DING: A separate Grading & Erosion Control application is required when the proposed land disturbances exceed the below
thresholds. If a Plan level application is required, a Pre-Application Conference is required prior to application submittal. Identify the
area of disturbance in each slope category:
SMALL
WASTEWATER SYSTEM: There is a separate application for septic systems and sewer connections. All habitable structures
must have an approved small wastewater (septic) permit, town sewer hookup permit, or other wastewater facility approved by
the
County Engineer’s Office before a building permit will be issued.
WETLANDS
AND WATERBODIES: Wetlands,
waterbodies,
and associated setbacks are required to be shown on the site plan. County
regulations may prohibit development in a wetland or waterbody and associated setback, except under specific circumstances. A
permit may be obtained for a limited amount of wetland disturbance. Contact the Planning Office for further clarification. The U.S.
Army Corps of Engineers regulates the placement of dredged and fill material into wetlands and other waters of the United
Sta
tes as
authorized pri
marily by Section 404 of the Clean Water Act (33 U.S.C. 1344). It is the landowner’s responsibility to
cont
act the Corps
prior to placing any fill in waters of the U.S. Information on Section 404 requirements can be obtained by
contac
ting the Wyoming
Regulatory Office at (307) 772-2300 or by visiting its website at www.nwo.usace.army.mil.
Ar
e there wetlands located on or adjacent to the site of the proposed structure or access?
Existing Slope of Area
Area to be
Disturbed
(sf)
Thresholds
Exempt
Plan
TOTAL DISTURBANCE
See below
sf but less than 1 acre
If disturbing 1 acre or more
5% or less
If disturbing less
than 12,000 sf
sf but less than 1 acre
If disturbing 1 acre or more
More than 5% up to
15%
If disturbing less
than 1,000 sf
but less than 1 acre
If disturbing 1 acre or more
More than 15%
No exemption
If disturbing more than
3,000 square feet
BDC Permit Application
3
Effective 1/1/2020
EXTERIOR MATERIALS: If metal materials are used, provide a sample with application. All exterior finishes are required to be
earth tone in color and non-reflective prior to installation.
Roof: Material/Type: Color:
Siding: Material/Type: Color:
SITE DEVELOPMENT: Site development is the area of the site that is physically developed; it is generally the inverse of landscape
surface area. Site development includes the area of the site that is covered by buildings, structures, impervious surfaces, porches,
decks, terraces, patios, driveways, walkways, parking areas, and regularly disturbed areas such as corrals, outdoor storage, and
stockpiles.
Footpr
int of Existing Structures/Buildings
Footprint of Proposed Structures/Buildings
Paved and unpaved driveways and parking areas
Decks, porches, patios, terraces (including sand-set), sidewalks, etc.
Other areas of the property which are not vegetated (corrals, riding arenas, etc.)
TOTAL
BUILDI
NG COMPOSITION: The following information should be shown both here and on the submitted plans, whether the project is
a new building or a tenant improvement. All buildings are to be designed to the requirements of the most recently adopted version of
the building code.
Type of Construction:
Sprink
lered? Yes No
Gross Floor Area: Height (in feet):
Floor Area Above Grade: Number of Stories:
Floor Area Below Grade:
OCCUPANCY GROUP: A list of group types can be found in Section 302 of the IBC. Occupancy loads can be found in Section 1004 of
the IBC. Rooms or areas designed for the use or storage of hazardous materials shall submit a list of the materials to be
use
d/stored
and the quantities to be housed in the structure.
For buildings with multiple occupancies, please complete the following (attach additional sheets if necessary):
1. Occupancy Group
2. Occupancy Group
Actual Area Occupant Load
Actual Area Occupant Load
3. Occupancy Group
Actual
Area
Occupant
Load
4. Occupancy Group
Actual A
rea Occupant Load
TOTAL AREA TOTAL OCCUPANT LOAD
BDC Permit Application
4
Effective 1/1/2020
ADDI
TIONS AND REMODELS: In addition to the information in the previous section, additions and remodels should also include
information on the following.
Existing Occupancy Group:
Area of Remodel/Addition: Existing Occupant Load:
Are any floor area increases requested?
Basis for increase
PARKING SPACES AND LOADING BAYS: Identify the number of parking spaces and loading bays on the property.
Total Number of Spaces
Disability Parking Spaces
Loading Bays
EXTERIOR LIGHTING: Exterior lighting information listed below shall include all fixtures, including but not limited to, lighting
attached to structures, poles, the earth, or any other location. Total numbers shall include all new lighting as well as existing
lights on the property. For existing light fixtures, please include numbers of fixtures and maximum lumen per fixture. Your
application shall include a manufacturer’s product specification sheet for all outdoor lighting and a lighting plan in the drawings.
Commercial applications shall include description of adaptive controls and plan for lighting reduction. Complex uses may require
additional information during the application review.
ESTIMATED COST OF CONSTRUC
TION: Please list the estimated cost of construction below. This figure should be the actual cost of
construction, which will be reported to the Census Bureau. The Building Department calculates a separate valuation for
the
Building
Permit Fee.
$
ENERGY CONSERVATION CODE: Energy mitigation fees shall be assessed for new construction and additions of more than 2,500
square feet of conditioned space. Energy mitigation fees shall also be assessed for heated hardscape areas.
Fixture Model or Description
No. of
Fixtures
Shielded
(Y/N)
Light Color (Kelvin)
Max Lumen per Fixture
Lumens Total
Ex: Cornice P5634 sconce
3
Y
3000
623
1869
Lumen Total All Types
BDC Permit Application
5
Effective 1/1/2020
SUBMITTAL REQUIREMENTS: This checklist is part of the application and MUST be completed by the owner or the
authorized agent. Plans found to be insufficient at the time take-in, will be returned to the owner/agent for corrections. More
information may be required at the time of review. Should the plan be revised by the applicant either during the review process or
after a permit is issued, the time frame for review will begin anew. Additional fees may be applicable. Revisions are required to be
submitted with a Letter of Transmittal for Building Permit Revisions, available on the County’s website. All the following
information is required to be on the plans or general notes, including special conditions.
Key: Y = meets submittal requirements
N = missing or incomplete information – letter of explanation required
NA = not applicable to this application
General Req
uirements:
2 CD’s & 2 Complete sets of plans including architectural, structural, mechanical, plumbing, fire sprinkler, electrical,
and material specification plans are required to be signed and sealed by the appropriate design professional (WSS
33-4-117). For specifications regarding fire sprinkler and electrical plans, contact the Jackson Hole Fire EMS Dept. at 733-
4732.
The plan cover sheet shall summarize the project showing square footages of each floor and total square footage of
proposed structure; size of the property, impervious surfaces and Landscaped Surface Ratio; construction and occupancy
typ
es.
For residential occupancies, the total number of sleeping units and number of accessible units, Type A units and/or Type B
units; and applicable codes shall also be required.
Special Conditions:
Structures within the Wildland-Urban Interface must show compliance with the Fire Marshal’s requirements by means of
details and/or notes on the submitted plans.
Note that structures greater than 5,000 gross sq. ft. are required to be fire sprinklered.
Structures
located within the FEMA, Special Flood Hazard Area shall show
compliance
with the
Flood-Resistive
Construction
requirements of the IBC.
Plans for
structures
located in areas subject to seasonal high ground water from spring runoff or
irrigation,
shall be provided
with details showing protection of the structure and all insulation, electrical, plumbing and mechanical systems, from
damage due to moisture and/or mold, by licensed design professionals, or shall be slab on grade.
Architectural Drawings(drawn to scale and as close to 24” X 36” as possible):
Architectural and structural elements shall be drawn to a scale of ¼” = 1’
Description of uses and the proposed use group(s) for all portions of the building. Architect shall indicate the design
approach for mixed-uses (as applicable).
Proposed type of construction of the building.
Fully dimensioned drawings to determine areas and building height.
An egress plan showing occupant loads of each room, for each floor and cumulative occupant loads at each exit. Show exit
arrangement and sizes, corridors, doors, stairs, etc.
Location of exit signs/means of egress lighting, including power supply.
Accessibility scoping provisions.
Description & details of proposed special
occupancies
such as a covered mall, high-rise, mezzanine, atrium, public garage, etc.
Adequate details to evaluate fire resistive construction requirements, including data substantiating required ratings.
Details of plastic, insulation, and safety glazing installation.
Details of required fire protection systems.
Site Plan (drawn to accepted engineering scale on sheets as close to 24”x36” as possible): Large land parcels should have two site
plans - one showing property in relation to adjacent land parcels with area to be developed identified, and a second, of smaller
scale, showing proposed development and associated structures within 100 feet not to exceed 24” x 36” including the following
information:
All site plan requirements for Planning and Engineering are shown including, but not limited to, all easements, all utility
locations, water lines, gas tanks, lines and meters, electrical vaults, lines and meters, sewer lines and cleanouts. Buried
utilities shall show the depth, bedding, and back fill requirements.
Entire property with dimensions of boundaries and north arrow. Show scale.
Location of existing and proposed structures or additions, including porches, balconies, terraces, walkways, decks, eave
overhangs, and chimneys.
BDC Permit Application
6
Effective 1/1/2020
Show distances of proposed structures or additions from property lines, right-of-way lines, creeks, streams, rivers, ditches,
ponds, and wetlands.
Names of adjacent streets or roads.
Locations of driveway and parking areas. New driveways entering onto a County road or State highway require a County
access permit.
Grade lines for slopes of 5% or greater.
Proposed and/or existing location of well, septic tank and leach field as applicable.
Location of wells, septic tanks, and leach fields on adjacent properties if within 100 feet of your property.
Locations of any wetlands on property.
Show landscaping conforming with Division 5.5 of the Teton County Land Development Regulations.
Location of areas designated for snow storage.
Location of buried utilities located or proposed for site.
Location, height, and type of any fencing proposed.
Exterior Lighting:
Provide a site plan depicting all proposed exterior fixtures. This includes but is not limited to, lighting attached to proposed
and existing structures, poles, the earth or landscaping fixtures, or any other location.
Provide a manufacturer’s product specification sheet for each type of fixture. This shall include details on shielding,
maximum lumens, color or Kelvin temperature and light trespass details. This can be individual sheets submitted with the
application or inserted on the exterior lighting plan.
Description of proposed adaptive or automatic lighting controls that extinguish exterior lighting when sufficient daylight is
available, such as timers, sensors, automation systems, etc.
Description of light reduction wherein the total exterior lighting shall be extinguished OR reduce by at least 30% at 12:00
AM.
Structural Plans and Engineering Details:
Soils report indicating the soil type and recommended allowable bearing pressure and foundation type.
Signed and sealed structural design calculations which support the member sizes on the drawings.
Local design load criteria, including: frost depth; live loads; snow loads; wind loads; earthquake design data; other special
loads.
Details of foundations and superstructure.
Provisions for required special inspections.
Applicable construction standards and material specifications (i.e., masonry, concrete, wood, steel, etc.).
Engineer shall specify any Special Inspections required for project.
Mechanical:
Complete signed and sealed (WSS 33-4-117) plans and specifications of all heating, ventilating and air conditioning work.
Complete information on all the
mechanical
equipment and materials including listing, labeling, installation and compliance
with specified quality control standards.
Details on the HVAC equipment including the equipment capacity (Btu/h input), controls equipment location, access and
clearances.
A ventilation schedule indicating the outdoor air rates, the estimated occupant load/1,000 ft2, the floor area of the space
and the amount of outdoor air supplied to each space.
The location of all outdoor air intakes with respect to sources of contaminates.
Duct construction and installation methods, flame spread/smoke development ratings of materials, flexible air duct and
connector listing and duct support spacing.
Condensate disposal, routing of piping and auxiliary and secondary drain systems.
Required exhaust systems, routing of ducts and termination to the exterior.
Complete details of all Type I and II kitchen hoods, grease duct construction and velocity, clearance to combustibles and
fire suppression system.
Details of all duct
penetrations
through fire
resistance
rated assemblies including shaft, fire dampers and/or smoke damper
locations.
Method of supplying combustion air to all fuel fired appliances, the location and size of openings and criteria used to size
the openings.
Details on the venting the products of combustion from all fuel burning appliances including the type of vent system, the
sizing criteria required for the type of vent and the routing of the vent.
Boiler and water heater equipment and piping details including safety controls and distribution piping layout.
BDC Permit Application
7
Effective 1/1/2020
Details on the type of refrigerant, calculations indicating the quantity of refrigerant And refrigerant piping material and the
type of connections.
Complete details on the gas piping system including materials, installation, valve locations, sizing criteria and calculations
(i.e., the longest run of piping, the pressure/pressure drop).
Complete signed and sealed (WSS 33-4-117) plans and specifications of all plumbing work.
Plumbing fixture specifications including identification of the applicable referenced quality control standards and the
maximum flow rates for the plumbing fixtures.
The basis for the number of plumbing fixtures provided including the occupant load used, the use group and
fix
ture rate
from the plumbing code.
Complete dimensions for bathrooms, the location of plumbing fixtures and the wall and floor surface materials.
Site plan, which indicates the routing of the sanitary, storm and water service with the burial depths for all sewers and
water service.
Water distribution system sizing criteria and calculations.
Water supply and distribution piping plan showing the incoming water supply, distribution piping, pipe size, the location
of water hammer arrestors and the location of the valves.
The location of all backflow preventers, the type of backflow preventers provided for each piece of equipment or outlet
and the specified quality control standards referenced in the code.
Drainage system piping plan showing the layout of all piping, of plumbing fixtures and the location of cleanouts.
Riser diagram (s) of the drain, waste and vent piping including the building drain, all horizontal branches and the
connections and layout of all fixtures. Pipe sizes, direction of flow, grade of horizontal piping, drainage fixture loads and
the method of venting all plumbing fixtures.
The location of all indirect waste connections, standpipes, grease traps and separators.
Complete details of the water heater, the method of supplying tempered water to accessible fixtures and the temperature
and pressure relief valve discharge.
Complete details of the method of draining storm water from the roof including calculations to verify pipe and/or gutter
sizes, the location of all roof drains and the roof area that each group of roof drains is intended to serve and an independent
secondary roof drainage system.
Piping material specifications to verify compliance with the specified quality control standards for all sanitary, storm and
potable water piping (e.g., ASTM B88 for copper pipe), the type of joints and connections for all piping, the pipe hanger
support spacing and details of anchorage and bracing.
Sprinkler Systems:
Complete signed and sealed (WSS 33-4-117) plans and specifications for the sprinkler system and related equipment.
Description and locations of uses within the building.
Design details in accordance with the appropriate reference standard (i.e. NFPA 13, 13D, 13R) as referenced by the building
code.
Design calculations indicating the discharge requirements of the system with evaluation of the arrangement and source of
the water supply.
Results of a current flow test indicating the location and date of the test.
Working drawings indicating all pipe sizes and the spacing between branch lines and sprinklers on the branch line.
Material specifications and equipment specifications. All materials used should be verified that they are installed in
accordance with their listing.
Wildland Urban Interface
_______ Wildland review printed on plans
_______ Details showing wildland review requirements
BDC Permit Application
8
Effective 1/1/2020
Accessibility: The Accessibility Review will cover the scoping requirements in Chapter 11 and other accessibility related
requirements mainstreamed throughout the applicable building code. Technical requirements covered will be based on the
applicable edition of ICC/ANSIA117.1. Accessible and Usable Buildings and Facilities. Any federal accessibility provisions, laws or
regulations are beyond the scope of this review.
Complete signed and sealed (WSS 33-4-117) architectural plans and material specifications of all work. Details and plans
drawn to scale with sufficient clarity, details and dimensions to show the nature and extent of the work propose.
Site plan including the following information:
Size and location of all new construction and all existing structures on the site.
Location of any recreational facilities (i.e., pool, tennis courts, etc.)
Established street grades, accessible routes from building exits to public ways and their grades and proposed
finished grade.
Accessible parking, other locations of public access to the facility, accessible exterior routes and locations of
accessible entrances.
Architectural plans and specifications to include:
Adequate details and dimensions to evaluate the accessible route to areas required to be accessible, including
corridors, doors, protruding objects, maneuvering clearances, clear floor space at fixtures and controls, etc.
Accessibility
provisions
including but not limited to access to services, eating, listening systems,
accessible
fixtures,
elevators, work surfaces, etc.
In residential occupancies, indicate which units are accessible, Type A and/or Type B. Indicate requirements for
each type.
Accessible plumbing facilities and details.
Tactile signage provided.
Details of required fire protection systems.
CERTIFICATE OF OCCUPANCY REQUIREMENT: Before occupying your project, you must have a final inspection by the Building
Department and other appropriate County agencies. Following these inspections, a Certificate of Occupancy may be issued.
Occupation of the proposed building in whole or in part without a Certificate of Occupancy may be subject to remedies provided
under Wyoming law.
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, the undersigned swears that the
foregoing is true and correct, and if signing on behalf of co-owners, multiple owners, corporation, partnership, limited liability
company, or other entity, the undersigned hereby swears that this authorization is given, to the full extent required, with the
necessary and appropriate approval, which authorizes the undersigned to act on behalf of such entity and/or owners. I agree to
comply with all County regulations, Building Codes and State laws relating to the subject matter of this application and hereby
authorize representatives of this County to enter upon the above mentioned property for inspection purposes.
In signing this application, I acknowledge that the County'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 County agencies and payment of any fees due.
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Form 83001: COMMERCIAL BUILDING PERMIT (BDC) APPLICATION Planning (Teton County Wyoming Government)

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Completed 18 July 2020

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