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Depending on the complexity of the design I will either start with a sheet-metal feature or solid modeling and then convert to sheet metal. The more complex (multiple compounded angles) the more likely I am to start off with solid modelling and then convert to sheet-metal at the appropriate point. I find it a whole lot easier in the design process for complex sheet metal work.
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I use mirror in all aspects, sketch, features, bodies and final parts (lefts and rights). Never had too many issues with it.
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My go to for assemblies is SSP method, and rarely use multi-body sheet metal parts (we do not weld much), more mechanical assembly type work. Mirrored and pattern parts is a definite yes.
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I use hole wizard for all holes type. I believe it works just as well as it does on non sheet metal parts.
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As for parts that have many bends, I guess it’s the same as any other parts (use of patterns…) and ensure manufacturability. I am not too sure what you mean be ‘flexed to fit BOM’.