You basically have to have a garage with power to buy one. There is a good reason they aren't as prevalent in the city as they are in the valley.
You can sometimes get it installed in a condo with underground parking, but even that is hard, and if you're just renting, it's a lot of hassle to go through. I've seen stories about people being charged >$500/mo for the hookup (with unlimited electricity, true) and absurd buildout costs.
SF is the most geographically close, high income center near SV, and yet it doesn't have many Model S's, despite the strong coolness factor that it'd get being so geographically close by. Some surreal proportion of Model S sales must be in SV...