In the "good old days" it was certainly possible to do board design using 2x or 4x sized Bishop Graphics tape for lines, vias, etc. You applied them to transparent mylar sheets corresponding to board layers.

But now, sheesh! You need to carefully constrain the PCB CAD program so that all the lines match to within 0.1" or less. And, as you mention, that's just the tip of the design iceberg.

It's no longer possible to layout computers at low cost in a garage. Oh, well. Now hipsters sit around in open offices in SOHO and create silly apps.