Try it! You can download a server repack that gives you everything you need to install the server at:
http://wiki.eqemulator.org/p?Akkas_P...epack&frm=Main
Installing from source is also possible but requires you understand the tools and technology, easier in Windows than in LINUX but of course LINUX is the lightest weight server (which was a concern for me since my server runs on Amazon ECS so lighter=cheaper!)
MOST people modify the database and quest scripts (requires PERL/LUA and SQL knowledge), some people modify the server code (C++/SQL), few people use Detours to modify client behaviour and detect cheating (Visual C++, DLLs), and almost nobody (?) actually creates completely custom zones AFAIK.
If your zone has objects hard coded (i.e. wizard portals) then you would have to change the zone files and distribute them. Some things (like wayfarer's camps, Froglok home in RM, LDON portals) are doors and objects so easy to change right in the database and doesn't require any file distribution. Messing with spells requires you send out a new spells_us.txt but thats pretty easy.
Give it a shot, makes you appreciate Nilbog and the staff much much more when you see the stock PEQ database.
Regards,
Mg