San Fran:
Coit Tower - Go up the tower, worth it for the view.
Musee Mecanique - Great collection of old and very old arcade games and other coin operated things.
Fishermans Wharf - It's wonderfully awful.

Lombard St.
Walk across the Golden Gate Bridge
Walk through Golden Gate Park - It's huge and takes hours.
Japanese Tea Garden in Golden Gate Park
Union Square
Use the cablecar - see the note at the bottom.
Chinatown
Haight Street and Castro district.
Lombard Street
Giants game at AT&T park - may have to buy tickets in advance.
Delores Park - Stop off at Tartine for a cake on the way and Bi-Rite Creamery for ice cream too.
Alcatraz - Go early so you can spend as long as possible there. You will have to book in advance.
The Bone Room - Odd.
Paxton Gate - also odd, but wonderful.
The Pirate Shop
Places to eat:
Giordano Bros - Pittsburgh style sandwiches are superb.
Delfina
Tartine - Breakfast buns first thing in the morning.. Yum.
Bi-Rite Creamery - Great icecream
Pinecrest Diner - Typically English service, they left you alone unless you wanted something. But the food was pretty good.
House of Prime Rib
Jardiniére by Traci Des Jardins - absolutely superb.
Ritual Coffee, Four Barrel Coffee, Sightglass Coffee and Flywheel Coffee - all excellent.
If you're going to be in San Fran for a few days, we'd really, REALLY recommend getting a MUNI pass. They run for 1, 3 of 7 days. You can hop on and off the busses and the cablecars. Otherwise it's $2.25 per bus trip, or $7 per cablecar trip...
We got the 7 day one and is paid for itself in about 3 days.
Vegas:
Pinball Hall Of Fame
Freemont St - again wonderfully awful.

Atomic Test Museum
Plane out to Grand Canyon at 6am, watch the sun rise over the country, be pretty much alone on the edge of the canyon.
Take in a show. I'd recommend Penn & Teller.
The Neon Museum. Take the earliest night tour you can and the place starts to light up in the dark.
Mob Museum
Rhyolite Ghost Town
I'm sure I've missed stuff. We spent 10 days in San Fran, 4 days driving to Vegas via Yosemite, Sequoia and Death Vally *in a classic convertible Mustang... 46°C with the roof down... Oh yeah.

* and then 6 days in Vegas. We could have very happily spent more time in all of the above places, except Death Valley, too hot.