Residential Paint Grant Application

Zephyrhills
Community Redevelopment Agency

Paint Voucher Program 
Application

 Property Owner’s Name _________________________________________________________________________________


Property Address_______________________________________________________________________________________


Mailing Address _______________________________________________________________________________________


Phone Number ___________________________________       Cell Number ____________________________


E-mail Address _______________________________________________________________________________________


Supporting Data Checklist must be included with application. 

Application will not be reviewed without all supporting data. 

Square footage of home ____________________________________________

Estimate of Cost for Paint ___________________________________________


Type of Paint ______________________________    Colors of Paint ____________________________________________


Check one

______    I will be doing the work.

 ______   I will have a professional completing the work. (A written estimate is
                required with the cost of paint itemized from other costs).

 

Owner may only apply for one Paint Voucher

I hereby submit the grant application, color samples and estimate for the proposed project and understand the Zephyrhills CRA Board must grant approval. No work shall begin and funding is not guaranteed until the CRA Board approves completed application and written approval is received. I agree to place a CRA Grant sign for the duration of the project and agree to return the sign. I further understand that the project must be completed within 6 months from date written approval is received and the reimbursement will not be paid until the project is completed. I agree to leave the completed project in its approved colors for a period of 2 years from the date of completion. I also understand a W-9 is required for tax purposes.


_____________________________________________
Print Name



_____________________________________________          _____________________________
Owner Signature                                                                         Date

 



Paint Voucher Program 
Supporting Data Checklist

 

Checklist must be submitted with application

 

Paint:

______  Provide samples of the three colors chosen: Body – Trim – Accent 

______  Note on sample which is body color, trim color, and accent color. 

______  Submit W-9 for tax purposes.

______  Submit written estimate from painter of your choice, excluding labor and materials or written estimate of paint cost.


Attach Color Sample