Fill - Free fillable Form 83001: RESIDENTIAL BUILDING PERMIT (BDR) APPLICATION Planning (Teton County Wyoming Government) PDF form

BDR Permit Application

Effective 1/1/2020

RESIDENTIAL BUILDING PERMIT (BDR) 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

r Office Use

Only

BDR

SWF/SWP GEC

PROJECT:

PLEASE CALL AND SCHEDULE A TAKE-IN WITH THE PERMIT TECHNICIAN BEFORE BRINGING IN THIS

APPLICATION (307) 733-7030.

Please type or fill out this application in ink

only.

Name/Description:

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:

APPLI

CANT/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:

Name:

Phone:

Mailing Address: City, State:

Email: ZIP:

ONTRACTOR: Contractors are required to be licensed in the Town of Jackson. A property owner may act as the general contractor

for his/her primary residence only.

Name: Phone:

Mailing Address: City, State:

Email: ZIP:

License No.

BDR Permit Application

Effective 1/1/2020

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 here.

Is the property located in the Wildland Urban Interface?

PROPOSED ACCESS:. An approved road access permit must accompany this application when a new access from a State or County

road is proposed. Please contact either the Wyoming Department of Transportation or the Teton County Road & Levee Department.

A copy of the approval shall be included in your application.

Wyoming Department of Transportation Teton County Road & Levee Department

1040 E. Evans Lane, Jackson 3190 S. Adams Canyon Drive, Jackson

(307) 733-3665 (307) 733-7190

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

Other (please identify):

If the designation is not Zone X, have you submitted a Floodplain Development Permit Application to Engineering?

GRADING: 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. If adding a bedroom with an existing septic system, provide

confirmation from the County Sanitarian that system is sufficient.

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 prima

rily by Section 404 of the Clean Water Act (33 U.S.C. 1344). It is the

landowner’

s responsibility to contact the Corps

prior to placing any fill in waters of the U.S. Information on Section 404 requirements can be obtained by contacting the Wyoming

Regulatory Office at (307) 772-2300 or by visiting its website at www.nwo.usace.army.mil

Are there wetlands located on or adjacent to the site of the proposed structure or access?

BRIDGES: A separate Bridge Permit application is required. All bridges are required to be engineered to support the imposed

load of the largest fire apparatus, which may be used on it, and shall meet design requirements of the AASHTO Standard

Specification for Highway Bridges.

Are there any bridges proposed for the site?

Existing Slope of Area

Area to be

Disturbed

(sf)

Thresholds

Exempt

Statement

Plan

TOTAL DISTURBANCE

See below

If disturbing at least 12,000

sf but less than 1 acre

If disturbing 1 acre or more

5% or less

If disturbing less

than 12,000 sf

If disturbing at least 12,000

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

If disturbing at least 1,000 sf

but less than 1 acre

If disturbing 1 acre or more

More than 15%

No exemption

If disturbing 3,000 sf or less

If disturbing more than

3,000 square feet

BDR Permit Application

Effective 1/1/2020

SITE DEVELOPMENT: Please identify the following areas in square feet.

Footprint 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

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:

UTILITIES AND HEAT SOURCE: All utilities are required to be buried.

Are utility lines and propane, gas, or oil tanks buried?

Identify heat source and location (such as base board heat/every room, oil-fired hydronic heat/garage, gas or electric forced

air/crawl space):

NUMBER OF BEDROOMS AND BATHROOMS ON PROPERTY: The addition of a bedroom(s) may require that you upgrade your

septic system. Please include all bedrooms, bathrooms and kitchens located on the property.

Existing Proposed (New) TOTAL

Bedrooms

Bathrooms

Kitchens

FLOOR AREA ON PROPERTY: Habitable floor area is the floor area that can be used for living purposes, usually having access to

heat, plumbing, and electricity. Habitable floor area includes studios, exercise rooms, offices, and similar spaces. It also includes

foyers, hallways, restrooms, storage, and other common areas within a building. Non-Habitable floor area includes barns,

garages, sheds, unfinished attic space over 5 feet in height or accessory structures with 3-sides.

Existing Proposed (New) TOTAL

Habitable, above grade

Non-Habitable, above grade

TOTAL FLOOR AREA ABOVE GRADE

Habi

table, below grade

Non-Habitable, below grade

TOTAL FLOOR AREA BELOW GRADE

If proposal includes non-habitable space how much of it is a garage:

If the proposal includes a remodel of existing space,

identify the square footage to be remodeled:

______________ habitable

______________ non-habitable

If proposal includes decks or porches more than 30” above grade or covered decks,

identify the square footage:

BDR Permit Application

Effective 1/1/2020

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.

DITIONAL PLANNING INFORMATION: Please answer the following questions:

Will the dwelling be rented on a short-term basis?

Will a mobile or manufactured home or conventional camping unit be used as temporary shelter?

If yes, a Basic Use Permit application is required.

What is the height of the structure? The height of a building or structure is the vertical dimension measured from any

point on the exterior of the building or structure to the nearest point of finished grade.

How many total parking spaces are proposed? Includes indoor and outdoor spaces.

Is any fencing proposed as part of this application? If yes, please show location and design on the site plan.

ESTIMATED COST OF CONSTRUCTION: 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.

WATER SUPPLY: Each

dwelling designed for human habitation shall be provided with an approved water system. This can be a

private well, community or municipal water system. Applications for an Appropriation of Groundwater (well permit) are handled

through the State Engineer’s Office. Please show well or water system connection on site plan.

AFFORDABLE HOUSING REQUIREMENTS: Affordable housing fees may be assessed for homes with habitable floor area over 2,500

square feet, including habitable basement. Please see http://www.tetonwyo.org/pdbldg

or contact the Planning & Development

Office for the current fee schedule.

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.

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

Fixture Model or Description

No. of

Fixtures

Shielded

(Y/N)

Light Color (Kelvin)

Max Lumen per Fixture

Lumens Total

Ex: Cornice P5634 sconce

3000

623

1869

Lumen Total All Types

BDR Permit Application

Effective 1/1/2020

Format:

Two copies of plans, printed in ink. Plan size shall be as close to 24” x 36” as possible.

A CD/PDF file of the plans including structural, mechanical and electrical. Structural calculations, project manuals and

similar supporting documentation shall be submitted in PDF format.

Plans shall be to scale with scale indicated for each drawing; pages shall be numbered.

All pages shall bear owner’s name, designer’s name, date of drawings, sheet number and description of work shown.

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 IRC.

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 (when prepared by a licensed architect, must be stamped and signed, drawn to scale and as close to 24” x

36” as possible):

Cover sheet showing the applicable codes as adopted by Teton County, owner, contact information, legal description and

address.

Dimensioned

floor plans for each floor,

including

details for stairs,

handrails

and guards. Note: guards required for surfaces

elevated more than 30” as measured horizontally 36” from the open sides.

Doors shall indicate size and direction of swing.

Show location of smoke and carbon monoxide detectors and note the inter connection.

Provide the size and location of the crawl space and attic accesses. Note: access and a clear path of travel (24” x 30”) not

exceeding 20 feet in length shall be required to all mechanical equipment located in crawl spaces or attics.

Indicate fire separation for garage walls, ceilings and their supporting elements common to the dwelling unit.

Provide exterior elevations (all sides) of the building indicating existing and final grades.

Interior cross sections showing room ceiling heights and headroom at landings and stairs with rise and run called out on

the plans.

Window details showing head and sill height and a schedule showing call-out sizes and indicating which units are required

for egress or tempered glass. Egress units should also be indicated on the floor plans.

Provide details of egress window wells to include size and depth when required. Wells deeper than 44” shall show window

swing a permanently installed ladder.

Site Plan (Drawn to Accepted Engineering Scale on Sheets and as close to 24”x36” as possible): Large land parcels should have two

site plans

showing the property in relation to adjacent land parcels with area to be developed identified, and of smaller

scale

showing proposed development and associated structures within 100 feet.

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.

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.

BDR Permit Application

Effective 1/1/2020

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.

Building Details:

Indicate the depth of foundation from finished grade to bottom of footing

Show or describe compliance for radon mitigation below living space, including gas-retardant barriers.

Provide wall section(s) showing exterior finish, weather barrier, structural sheathing, building envelope insulation, vapor

barrier and interior finished surfaces.

Indicate R-values for roof, walls, floors, crawlspace walls, basement walls, concrete slabs and the window U-value.

Indicate ignition or thermal barriers for exposed foam plastic insulation, if required.

Provide roof/attic and crawlspace ventilation details

Indicate foundation water proofing or damp proofing

Flashing details and/or notes have been provided for all required locations, including but not limited to, windows,

doors,

masonry

intersecting with framing, above projecting trim, where exterior walls are intersected by roofs or

decks.

Provide location, details and dimensions for ducts and personnel openings in all load bearing walls.

All underfloor walls shall have personnel openings with minimum dimensions of 24” in width by 30” in height as measured

from top of the footing to bottom of the header. These openings shall not be used for any other purpose

Provide location(s) of draft stopping and/or fireblocking. Also indicate the materials used.

Structural Plans and Engineering Details:

All structural drawings shall bear the name and signed stamp of the engineer of record. Such engineer shall be licensed to

practice in the state of Wyoming and shall be licensed for the discipline appropriate to the drawings bearing his/her stamp.

Structural drawings shall be accompanied by structural calculations executed by the engineer of record for the project.

The calculations shall be submitted in PDF format and bear a digital representation of the stamp of the engineer.

Structural Notes shall be included on the drawings and shall include: live loads, dead loads and special loads; ground snow

loads, roof snow loads and wind loads; seismic design category; site class; spectral response coefficients S

and S

, C

and

response modification R and analysis procedure used. Exception: Agricultural buildings open on two sides.

All structural plans shall include notes concerning special inspections in accordance with Chapter 17 and contain: required

Statement of Special Inspection; Qualification for a Special Inspector; Statement of Contractor Responsibility; required

inspections for seismic resistance; and provisions for structural observation when required by the

building

official or

registered design professional.

Provide location and details for ducts, plumbing and personnel openings through engineered shear walls and structural

members.

Exterior & Interior Stone and Masonry Veneer: Engineering Required for Veneer over 4 feet in Height

Indicate size, type and location of rock or stone veneer.

Details show attachment, support from below and supporting walls in accordance with requirements and limitations of

IBC Section 1405 for Seismic Design Category D.

Wood Burning Masonry Fireplace: Engineering Required unless otherwise approved by the building official

Show compliance for clearance to combustibles and required fire blocking

Indicate all directional changes in chimney walls and/or flue lining

Indicate compliance for chimney termination and spark arrestors

Indicate size, thickness, extension, and material type for mantles, hearths and supporting elements

Provide dimensions of the fireplace opening and depth

If the fireplace is located on an exterior wall, provide a detail of the chimney attachment to floors and roofs more than 6

feet above grade

Provide dimensions and location of lintel, throat, damper, smoke chamber and flue

BDR Permit Application

Effective 1/1/2020

Provide a combustion air vent, showing size, material, and location within the firebox. Include the termination at the

building exterior

When used as a structural element of the building, show attachments and reinforcement of beams, etc.

Gas Fireplace/Heaters:

Provide the manufacturer’s name and model number of all vented gas fireplaces and fireplace heaters. Installation shall

be in accordance with the manufacturer’s instructions and currently adopted codes of Teton County.

Provide the size and location of the exterior combustion air openings.

Direct-vent fireplace/heaters are required for sleeping rooms.

Approved decorative gas appliances may be installed in fireplaces located in other areas only if the listing allows

operatio

of the appliance with glass doors in the closed position.

Mechanical: Design builds are not permitted. Provide mechanical plans.

Show the location of all gas appliances including, but not limited to, boilers, furnaces, ranges and cooktops, vented

fireplaces and heaters and water heaters.

List heating equipment and efficiencies (AFUE and SEER ratings)

Show compliance with ACCA, Manual J (or equal) for space heating or cooling equipment.

Show location of gas shut-off and regulator.

Required drain pans and combustion air shall be shown on the plans

Indicate access and clear path to all mechanical equipment located in crawl space or attic.

Provide locations and cfm rating of all ventilation fans Note: if exhaust hoods are greater than 400 cfm, provide make up

air design.

Provide details and/or notes for proper vent termination of all appliances

Show access and clearances for all equipment and appliances including clearances above the cooktop

Provide the location of any condensate disposal

Provide fuel gas piping loads and distance from regulator to furthest appliance.

Provide location, details and dimensions for ducts and personnel openings in all load bearing walls.

All underfloor walls shall have personnel openings with minimum dimensions of 24” in width by 30” in height as

measured from top of the footing to bottom of the header. These openings shall not be used for any other purpose

Provide details on whole-house ventilation system.

Electrical: Details and notes on the plans shall provide the following information:

Location and ampacity of the service

Location of the Uffer ground, sized in accordance with NEC 250-50(c), as amended.

For additions, provide load calculations showing adequacy of existing service for additional loads.

Indicate the location of all panels and sub-panels

Provide the location and type of smoke detectors (Note: Smoke detectors must be interconnected)

Provide the location and type of all recessed lighting in the roof ceiling assemblies

Provide a light and outlet adjacent to mechanical equipment located in attics and crawl spaces.

Provide load calculations for services over 400 Amps.

TICE: Electrical plans for multi-family with services over 400 Amps shall be submitted, in duplicate, directly to the electrical

division of Jackson Fire/EMS. The electrical division will review the plans and issue the required permit. Submission may be made by

the applicant, but the permit shall only be issued to the owner or a State licensed electrical contractor. Consult the electrical division

for their specific requirements for plan submittals.

Plu

mbing:

Connection to the water supply shall be protected from backflow by a dual check or other approved backflow device.

Indicate type and location of such protection on plans.

If applicable, provide the location and type of backflow protection for lawn sprinkler system.

Indicate the location of all required exterior cleanouts on the plans.

Provide details and the location of all sumps, ejectors, floor drains, fixtures, water heaters, expansion tanks, and laundry

facilities.

Show required access to motors for jetted bathtubs.

Indicate location of access to concealed slip joints. Example: 2

story tub drains.

Provide required water heater and/or boiler combustion air openings, seismic bracing, drain pans, drain pan and T & P

relief valve terminations.

BDR Permit Application

Effective 1/1/2020

Fixtures with the elevation of flood level rims below the next upstream manhole cover must be protected with an approved

backwater valve. Indicate location and access.

Provide location, details and dimensions for ducts and personnel openings in all load bearing walls.

All underfloor walls shall have personnel openings with minimum dimensions of 24” in width by 30” in height as

measured from top of the footing to bottom of the header. These openings shall not be used for any other purpose.

Appliances located in garages shall be protected from impact and have their source of ignition a minimum of 18” above

the floor.

Energy:

All residences shall be designed to the insulation and fenestration requirements of Table N1102.1, Zone 7, of the

International Residential Code as amended by Teton County.

Provide a REScheck Compliance Certificate (www.energycodes.gov) showing compliance of building envelope design and

mechanical system.

Heated garage spaces with a design rate of energy usage equal to or greater than 3.4 Btu/h/ft

or 1.0 watt/ft

shall meet

all the requirements for heated spaces.

Show compliance with local amendment limiting fenestrations to 30% of wall area above grade.

Finished garages shall be insulated to the requirements of Table N1102.1.

All pools and/or spas shall be equipped with evaporative control covers that meet the requirements of ASTM F 1346.

All exterior landscape lighting shall be solar powered.

The first 5 feet of piping to storage water heaters shall be insulated.

NOTICE: Structures in excess of 2,500 sq. ft. of conditioned area and/or have heated hardscape, pools, spas, etc. are subject to

EMP fees.

Wildland Urban Interface

_______ Wildland review printed on plans

_______ Details showing wildland review requirements

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.

APPLI

CANT'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.

Signature of Applicant Date

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Form 83001: RESIDENTIAL BUILDING PERMIT (BDR) APPLICATION Planning (Teton County Wyoming Government)

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