Revit doesn't work like that...the scale of the view is set by the properties of each view placed on the sheet. The crop region, when adjusted, determines the extent of the view to show the elements in the view that you want to see. If the region is not cropped it will encompass the extents of the visible elements. The annotation crop is for annotative items only and cannot go inside the crop region...it will always be outside of it.
You can print to any paper size you have setup in the printer. If you want the views to be scaled properly you need to have a corresponding titleblock that is the size you want to print to. Fit to Page is, as you mentioned, not to scale...it will adjust everything in the view to fit on the size selected in the Print Settings Setup.
